Exploring the Potential of Exercise as a Treatment to Addiction

Exploring the Potential of Exercise as a Treatment to Addiction

By Kye Taylor

Every morning, as I arrive at work, I know that the events of my day will focus around one foundational purpose – How can I create an environment that will allow the men at our alcohol and drug treatment center to realize the power of exercise? While this challenge can often be daunting (it is not easy to compete with a comfy couch and Monday Night Football), there are shining stories of success that both re-energize my efforts, as well as provide proof to the men that such a metamorphosis is possible.

In July of 1992, Charlie Engel, a hardcore drug addict of ten years, gave up drugs for good after smoking crack cocaine in a seedy hotel room is Wichita, Kansas. The now 45 year old Engle, has since run across the Sahara Desert in North Africa, covering 4,300 miles enroute. Engle, who regularly runs 40-50 miles a day, is considered a legend in ultra-marathon running circles. Now, go ahead and add to the list the Gobi Desert, Atacama Desert, the Amazon rainforest, Vietnam, and the jungles of Borneo – not bad for a former addict.

Engle, in an interview in the September issue of Maxim Magazine titled “Running From Addiction: How the once mythical “runner’s high” is helping former users kick their habits, one mile at a time,” explained how his substance misuse actually prepared him for his new life. “Drug addiction was my training ground” said Engle. Engle elaborates on this notion, stating that “Without those 10 years of torture, there’s not a chance in hell I’d be doing the things I’m doing today. I figured out I didn’t need to trash my addictive traits in order to be good at something other than taking drugs.” Obviously, Engle is an extreme case, but he is not alone in his belief that the transition from a negative drug addiction to a positive exercise addiction is a powerful tool for recovery.

Another person who has experienced the redemptive powers of exercise is Todd Crandell. His remarkable story was featured along-side Engle’s in the same article, as both stories were too influential to be cut out. Not only has Crandell helped himself overcome a life of addiction, but also, he has founded a revolutionary organization called Racing for Recovery that now helps others do the same.

After being an addict for 13 years, it got to the point, says Crandell, that “When I woke up in the morning, my first thought would be, Damn, I’m still alive. How much of this stuff is it going to take for me to overdose and die?” In 1993, with beer in hand, after over a decade of addiction, Crandell decided to change his life for good. He started training to compete in the Ironman triathlon, consisting of a 2.4 mile swim, 112 mile bike, and 26.2 mile run. When asked of the appeal of competing in such a grueling event, Crandell remarks, “When I’m running, I feel like I’m on amphetamine. People say to me that I’ve just swapped one addiction for another addiction. They’re both highs, but one is destructive and the other is extremely productive.”

Since his life changing epiphany, Crandell has accomplished a lot, competing in more than a dozen Ironmans, writing a book entitled Racing for Recovery: From Addict to Ironman, as well as using his own money to start Racing for Recoverywhich has helped many others discover, like he did, how exercise can help them regain command over their lives, focusing their efforts in a positive direction towards a tangible goal. Aaron Dalley, a 28 year old recovering alcoholic, who lives and works at Crandell’s Racing for Recovery facility, breaks it down as follows “I wouldn’t say that if you go running you automatically get sober, but the exercise changes you. You sleep better. You eat better. It boosts your self-esteem, which makes it easier to concentrate on staying sober.”

Brain Chemicals Have Often Been Identified with the “Runner’s High”

Brain chemicals have often been identified with the “runner’s high” and with drug addiction. In his Maxim story, Frank Owen points to research on endorphins as a mood-lifting brain chemical that has it’s fair share of both proponents and critics. Other brain chemicals such as dopamine, serotonin, and epinephrine have also been identified in research.

A New Book Holds Promise for Those Struggling with Drug and Alcohol Addiction

So, what are we to make of all of this? How is it that exercise helps former addicts overcome decade long addictions? Dr. John Ratey devotes a chapter of his new book SPARK: The Revolutionary New Science of Exercise and the Brainto answering just such a question. Ratey spends much of the chapter weaving together case studies and his ‘alternative’ approach that incorporates exercise as a form of treatment for his patients. He uses stories from many of his own patients who have had success overcoming their addictions with exercises ranging from Dance Dance Revolution to jump rope. However, the truly fascinating parts come from Ratey’s explanation of the neuroscience behind his patients’ success.

Ratey explains, “What makes addiction such a stubborn problem is the structural changes it causes in the brain. Scientists now consider addiction a chronic disease because it wires in a memory that triggers reflexive behavior.” According to Ratey, exercise is perhaps the most powerful way to combat this structural change. “Exercise builds synaptic detours around the well-worn connections automatically looking for the next fix”, says Ratey. While this may be the most notable component in terms of addiction, exercise also has a restorative and rebalancing affect on the brain that Ratey goes on to discuss in depth.

There are two things important to note. Firstly, is that exercise does not merely induce a ‘runners high’, but it also stimulates the release of many neurotransmitters that help regulate normal brain function. Secondly, exercise actually changes the structure of your brain, creating new pathways that serve as alternatives to getting back on the merri-go-round that is addiction.

An Addiction Research “Giant” is Now Studying Exercise

As recently as this past June, the US-based National Institute on Drug Abuse (NIDA) held a two-day symposium, Can Physical Activity and Exercise Prevent Drug Abuse? Promoting a Full Range of Science to Inform Prevention, which gathered practitioners and basic, clinical, and translational researchers from various disciplines to share ideas.

Conclusion

As compelling stories of recovery such as Todd Crandell’s and Charlie Engle’s continue to emerge, it has become increasingly clear that exercise can be used as a powerful weapon in the fight against addiction. Here at Sunshine Coast Health Center, we have jumped on board of the paradigm shifting movement towards using exercise to overcome addiction.

While stories like Crandell’s and Engle’s help to lend authenticity to amassing scientific research regarding exercise and addiction, they also reinforce the need for continued research at the point in which neuroscience and exercise converge. Only through the continued scientific exploration by those such as Dr. John Ratey can we fully understand the potential of exercise as both a method of prevention and treatment to addiction.

For those who remain skeptical of the therapeutic value of exercise, consider for a moment any other proven and effective methods of treatment to addiction that are cheap, non-invasive, relieve mild depression, stimulate brain cell growth, and also trim your waist-line – Still thinking? That should be motivation enough to want to include exercise as part of your recovery!

Exercise Helps in Addiction Treatment

Struggling with Addiction? Exercise Might Help

By Hugh C. McBride

Strange as it may sound, the road to addiction recovery might start on a treadmill.

A series of studies evaluating the relationship between exercise and substance abuse has produced promising results, prompting the National Institute on Drug Abuse to offer $4 million in grant money for additional research into whether regular vigorous activity can prevent addiction.

“Exercise has been shown to be beneficial in so many areas of physical and mental health,” NIDA Director Dr. Nora Volkow said in a press release announcing a two-day conference on the role of physical activity in addiction prevention. “This cross-disciplinary meeting is designed to get scientists thinking creatively about [exercise’s] potential role in substance abuse prevention.”

The release said that more than 100 scientists were scheduled to gather at NIDA headquarters in Bethesda, Maryland, June 5 and 6 to plot a course for further exploration of this emerging approach to addiction prevention and rehabilitation.

SUCCESS WITH SMOKERS

Drug rehabilitation programs have long included exercise regimens to strengthen the bodies of recovering addicts and to occupy their time and minds. But a Brown University study in the late 1990s showed that regular vigorous activity could actually affect an addicted individual’s ability to remain abstinent.

The Brown study, which was led by Bess Marcus of the university’s Center for Behavioral and Preventive Medicine, evaluated the effects of exercise on 281 healthy but sedentary females who were attempting to stop smoking. For 12 weeks, all of the women in the study attended a weekly smoking-cessation program – but 147 participants were also enrolled in thrice-weekly wellness classes, while the remaining 134 participated in supervised exercise sessions three times per week.

According to a ScienceDaily article from June 16, 1999, the women in the study who participated in the exercise program were twice as likely to become and remain smoke-free as were the women who attended the wellness classes, but didn’t exercise:

• At the end of 12 weeks, 19.4 percent of exercisers had kicked the habit for at least two months – almost double the 10.2 percent rate of the non-exercising control group.
• Three months later, 16.4 percent of the exercisers and 8.2 percent of the non-exercisers were still not smoking.
• One year after the study, 11.9 percent of the exercisers remained smoke-free, compared with 5.4 percent of the women in the non-exercising group.

Even within the more successful exercise group, ScienceDaily reported, the percentages were best among those who had attended the greatest number of workouts. “Of these women, 47.2 percent had ceased smoking and stayed cigarette-free compared to 28.9 percent of the non-exercise group at the end of 12 weeks. A year after the program ended, 27.8 percent of women who had adhered to the exercise regimen had not smoked compared to 18.1 percent of non-exercisers.”

In a release distributed by the Brown University News Bureau, Marcus said that regular activity offered a wealth of benefits for individuals who were attempting to kick a tobacco addiction. “There are numerous health benefits to participating in an exercise program,” she said. “For starters, exercise helps you manage weight, stress, mood, anxiety, depression and blood lipids.”

A SIMILAR EFFECT ON OTHER ADDICTIONS?

The Brown study was not the first research involving exercise and addiction. Scott Winnail, Ph.D., who authored a study that was published in the December 1995 edition of the Journal of School Health, wrote that his research led him to conclude that increases in physical activity levels were associated with decreases in teens’ use of tobacco and marijuana.

But, as indicated by the importance NIDA officials attached to the organization’s recent seminar on the topic, the idea that the very act of exercising can increase an individual’s ability to overcome an addiction is a relatively new concept that merits additional evaluation.
Associated Press medical reporter Lauran Neergaard, who wrote a June 9, 2008 article on the NIDA conference, noted this interest may have been inspired in part by the following findings:

• Researchers have discovered that rats whose cages contained running wheels were less likely to ingest amphetamines than were more sedentary rodents.
• Exercise in humans is known to trigger the release of dopamine, a brain chemical that has been associated with mood improvements and depression relief.
• Studies have shown that elderly individuals who exercise have improved brain function and may, as a result, be less susceptible to the effects of dementia.

CONTINUED SUPPORT FOR EXERCISE

The recent studies and NIDA’s increased attention are part of a continuum of research and reports advocating regular physical activity to preclude the onset of a wide range of physical and mental diseases and conditions.
The President’s Council on Physical Fitness advises Americans to exercise daily as a means of reducing their risk of developing cardiovascular disease, type 2 diabetes, and some types of cancer. Regular activity, the council says, can lower blood pressure, slow the onset of osteoporosis, and reduce symptoms associated with arthritis.

And Dr. Daniel M. Landers of Arizona State University’s Department of Kinesiology has written that “We now have evidence to support the claim that exercise is related to positive mental health as indicated by relief in symptoms of depression and anxiety.”
The findings of these studies are encouraging many addiction treatment programs to include physical exercise that may also include such practices as yoga and Pilates.

Working out may help prevent substance abuse

WASHINGTON - Sure, exercise is good for your waistline, your heart, your bones — but might it also help prevent addiction to drugs or alcohol?

There are some tantalizing clues that physical activity might spur changes in the brain to do just that. Now the U.S. government is beginning a push for hard research to prove it.

This is not about getting average people to achieve the so-called runner's high, a feat of pretty intense athletics.

Instead, the question is just how regular physical activity of varying intensity — dancing, bicycling, swimming, tae kwan do — might affect mood, academic performance, even the very reward systems in the brain that can get hijacked by substance abuse.

What first caught the attention of National Institute on Drug Abuse chief Dr. Nora Volkow: A study found youngsters and teens who reported exercising daily were half as likely to smoke as their sedentary counterparts, and 40 percent less likely to experiment with marijuana.

Volkow knows — from her own 6-mile daily runs and from her scientific experiments — that the brain literally likes physical activity. Exercise seems to invigorate neurochemicals that sense and reinforce pleasure.

"In children, it's innate," she notes. "Children want to move."

But U.S. children are becoming more sedentary, as illustrated by the obesity epidemic, "screen time" replacing outdoor play and a drop in school physical education. And as youngsters approach adolescence, the run around the yard that used to be fun too often becomes a chore — the dreaded jog around the school track or the nagging to get off the couch. The sedentary teen turns into the sedentary adult.

"Why do we lose the ability to experience pleasure from physical activity?" asks Volkow.

Last week she brought more than 100 specialists in exercise and neurobiology to a two-day conference to explore physical activity's potential in fighting substance abuse, and announced $4 million in new research grants to help.

Drug treatment programs often include exercise, partly to keep people distracted from their cravings, but there's been little formal research on the effects.

The best evidence: Brown University took smokers to the gym three times a week and found adding the exercise to a smoking-cessation program doubled women's chances of successfully kicking the habit. The quitters who worked out got an extra benefit: They gained half as much weight as women who managed to quit without exercising, says lead researcher Dr. Bess Marcus.

She now is working on a larger study to prove the benefit.

Marcus cautions that people trying to kick an addiction have a powerful incentive to exercise. Could that possibly translate into prevention? Among the clues:

• Rats were less likely to ingest amphetamines if their cages had running wheels, suggesting exercise stimulated a reward pathway in the brain to leave them less vulnerable to the drug's rush.
• In people, exercise acts as a mild antidepressant and relieves stress. Depression, anxiety and stress increase risk of alcoholism, smoking or drug abuse.
• Volkow is intrigued that attention deficit disorder and obesity both involve problems with the brain chemical dopamine, one system that drugs hijack to create addiction.
• Baby monkeys who do not play enough in childhood have problems controlling aggression when they're older. The most aggressive tend to have defects involving the feel-good brain chemical serotonin — and binge-drink when researchers offer them alcohol.
• Back to rats, physical activity increases production of growth factors and stem cells in key brain regions important for learning and mood; increases formation of blood vessels; and strengthens communication networks between brain cells.

Together, that is far too little research to know if exercise really matters for substance abuse, scientists at the National Institutes of Health meeting cautioned.

Copyright 2008 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Could Exercise Regenerate Alcohol-Damaged Neurons?

Aaron Levin

Genetics and alcohol-induced inflammation appear to combine in complex ways to cause dependency, but in rats, at least, exercise reduces long-term damage to the brain.

Rats that drink like college students at a frat party are teaching researchers about how alcohol affects the growth and death of brain cells and providing insight into how alcohol produces addictive behavior. They may even point to ways to help alcoholics reach sobriety.

Alcohol's effects on the brain occur through a mixture of genetics and inflammation, Said Fulton Crews, Ph.D., a professor of pharmacology and psychiatry and director of the Bowles Center for Alcohol Studies at the University of North Carolina at Chapel Hill.

Crews delivered the annual Mark Keller Honorary Lecture at the National Institute on Alcohol Abuse and Alcoholism in November.

His alcoholism research for several decades has been based on the fact that neural stem cells continue dividing in adulthood and give rise to new neurons in the dentate gyrus of the hippocampus and the subventricular zone of the anterior lateral ventricles.

However, ethanol blocks development of new adult neurons, decreasing neural stem cell proliferation, reducing cell survival, and altering maturation of new neurons. Part of that effect is due to genetics, since rats bred to prefer alcohol exhibit greater brain damage after drinking than do controls.

Age is another factor. Adolescent rats are less sensitive to the intoxicating effects of alcohol, but are more likely to sustain brain damage.

A family history of alcoholism and lower age at drinking onset are known to increase the prevalence of alcohol dependence, said Crews. Adolescent rats show more damage in the forebrain from alcohol, and other studies have shown that damage in the orbitofrontal cortex leads to maladaptive decision making.

Crews' recent research has concentrated on how immune regulatory and transcription factors affect neurogenesis. For instance, CREB (cAMP response element-binding) proteins are transcription factors that increase or decrease the transcription of certain genes. Given the equivalent of binge-drinking doses of alcohol, rats show a dose-dependent decrease in CREB binding, which protects neurons, and an increase in necrosis factor-kB (NF-kB) DNA binding activity, a proinflammatory agent.

"Ethanol intoxication decreases neurogenesis, and cell death occurs during intoxication, not withdrawal," said Crews.

Crews and his colleagues also found that butylated hydroxytoluene (BHT)—an antioxidant used as a food preservative— blocks tumor necrosis factor-a (TNF-a), an inflammatory cytokine, in brain slice cultures and in vivo by blocking NF-k B activation. That observation led them to look more closely at the effects of inflammation. Giving BHT with ethanol produced some reversal of neuronal death bysuppressing the inflammatory reaction, leading Crews to speculate about whether diet plays a role in this process. Perhaps the BHT—much reviled by health-food advocates—might protect neurogenesis.

"Natural foods may not be as good for you in this case," he joked.

To test the role of TNF-a, he gave rats a dose of lipopolysaccheride, a bacterial toxin that produces inflammation. in an hour, the toxin produced a 1,000-fold increase in TNF-a in liver, serum, and brain. Levels in liver and serum dropped within hours, but brain levels stayed up, said Crews.

"Cytokines stay in the brain a long time," said Crews. "Ten months after a single dose of the toxin, brain levels remained high." Further study found that alcohol potentiated the toxin's effect in producing long-lasting effects of TNF-a, indicating a similar pathway. At the same time, alcohol also reduces brain levels of IL-10, an anti-inflammatory cytokine.

In another experiment, rats given high doses of alcohol for four days exhibited cognitive deficits associated with neurotoxicity in the dentate gyrus, which is involved with memory and learning. In a water-maze test, both control and alcohol-drinking rats learned equally well, but even three weeks into abstinence the alcoholic rats were much worse at relearning the task. They kept making the same mistake over and over again.

"Such perseveration in rats only brings to light how difficult therapy is for the human alcoholic," said crews. "They have to regenerate to relearn."

The implication, said Crews, is that neurons must be regenerated to provide a substrate for recovery. Yet that does seem possible once the extended, harmful inflammatory effects of alcohol fade.

"Within 20 weeks of stopping alcohol, the damage can be reversed," he said. "So if brain regrowth is useful for the return of executivefunction, how do we make the brain grow?"

Crews has an answer for the rats and maybe for humans, one that doesn't even require approval by the Food and Drug Administration.Heavy physical exercise is known to increase neurogenesis, he said, so he and his colleagues tried an experiment with three groups of rats. One group drank alcohol, but got no exercise. A second drank water and exercised.

"The third drank huge amounts of alcohol and also ran huge amounts," said Crews. The sedentary, alcoholic rats lost neurons, but running increased neurogenesis equally in both the water-drinking rats and the exercising, alcoholic animals, he said. Perhaps an exerciseregimen could reverse neurodegeneration, improve executive function, and help alcoholics along the path to recovery.

"Therapists should challenge their patients to engage in vigorous physical exercise and see if it helps recovery," he said.

An abstract of "Cytokines and Alcohol" is posted at <www.blackwell-synergy.com/doi/abs/10.1111/j.1530-0277.2006.00084.x>.

Exercise: the 13th Step to Beat Addiction!

Todd Crandell was 20-something and an up and coming hockey player with a promising future when he lost it all to substance abuse. After 13 years of drug and alcohol addiction, Crandell decided to enter recovery the traditional way — detox, support groups, AA meetings, the 12 steps etc. — but he, like many others, felt something was missing.

We are learning that one size does not fit all when it comes to addiction recovery programs. The 12-step programs have and will continue to help millions successfully recover from addictions. However, many recovery programs are now taking a more holistic approach when treating addictions — not just alcohol and drugs — but other addictions like cigarette smoking and binge eating.

The holistically oriented programs supplement the traditional approach of beating an addiction with lifestyle changes including exercise, nutrition, stress management and optimal rest. That’s why as a fitness trainer, I am now talking about addictions, because exercise can play a central role.

Exercising every day has been proven to positively impact an addict in many ways. For example, an active addict can lose structure and meaning to his/her day, but exercise immediately provides this. Exercise fills time and keeps the mind busy. The process of getting fit or actually training for a specific event builds confidence and gives the recovering addict a goal to work toward.

Exercise can also be beneficial in easing symptoms of anxiety and depression, which go hand-in-hand with addiction. An imbalance of neurotransmitters in the brain produces the anxiety and depression. Exercise not only impacts endorphins, but also increases levels of serotonin and dopamine, creating more balance. This produces the famous “runners high,” decreases anxiety, and provides an overall feeling of “calm.”

These were the benefits for Crandell, and they helped him overcome his addiction for good and get his life back on track. He is now helping others overcome addiction with the organization he founded called Racing for Recovery.

He says the holistic approach to recovery helped him “not only physically, but spiritually, emotionally, and intellectually, as well.”¹ In other words, the whole person. You can learn more about the organization at www.racingforrecovery.com.

Research shows that 75% of Americans know someone who has an addiction.² If you are struggling with addiction now, I urge you to seek out programs that encourage exercise. It has helped many others like Todd Crandell, and it could be just what you need to finally overcome your addiction.

From Hermit to Healer

By TOM CLARK
Philadelphia Daily News

Hermits are supposed to be recluses, out of touch with the world around them and unable to connect with anyone.
But that description doesn't quite fit North Philadelphia's hermit nun, Sister Margaret McKenna, 79, a Medical Mission Sister who has become a beloved figure in her community.

Twenty years ago, McKenna founded New Jerusalem Laura to help recovering drug and alcohol addicts overcome old habits and succeed in life.

But McKenna didn't come to North Philadelphia intending to institute social change: She came to get away from the world.

In 1989, she bought a run-down house on a desolate block of Norris Street near 20th. To her, it was a perfect place to realize her dream of establishing a hermitage based on desert spirituality, which, according to McKenna, holds that separation from the world can help one concentrate on and develop the essentials of Christian faith.

Shortly after her arrival in North Philadelphia, she found that the life of solitude and prayer she had hoped for would have to wait. Seeing the harsh realities of the neighborhood around her, she saw that something else was needed.

"What had the most impact was the addiction," she said. "Every time you'd look out the window you'd see deals or something going on about drugs. It seemed like whatever problems there were [in the neighborhood] were related to drugs."

Instead of continuing on with her life as a hermit and turning a blind eye to the world just outside her window, McKenna opened her door to those who had nowhere else to turn.

Since its foundation in 1989, New Jerusalem Laura has grown into a wide-reaching organization that operates from six Philadelphia houses.

The recovery community has since adopted the name New Jerusalem Now and features basic and advanced recovery programs.

Recently, the program has fallen on hard times. As a result of the economic downturn and city budget crisis, grants and donations are harder to come by, McKenna said. To raise donations, the program will hold a "Summer Soulstice" party on its block of Norris Street from 10 a.m. to 4 p.m. today.

"We have a holistic philosophy," said McKenna of the recovery program. "We want it to be an experience of a new way of life for them."

That way includes a highly structured program that engages recovering addicts through art, poetry, interfaith Bible study and community service - the backbone of the program.

McKenna said that members of the program are involved in various peace and justice efforts throughout the city. New Jerusalem runs an anti-violence program and its members are active in neighborhood-improvement initiatives.

"If society is what made you sick, you're not going to stay well unless you change society," she said, stressing service's crucial role in her program.

Plenty of good comes out of New Jerusalem, she said, and the neighborhood is taking note. While some folks might cringe at the thought of a drug-rehab house down the street, she says that the community has come to embrace the program and its members.

Despite the recent financial difficulties, McKenna said, New Jerusalem is looking into self-sustaining initiatives and will continue to forge ahead.

It will do so without her at the helm. She retired last year as director of New Jerusalem, but she remains involved in the program by leading Bible study every morning.

Although her role has changed, her impact is still felt by those whose lives she has touched.

"I think she's a saint," said David Ryle, 32, a program coordinator for New Jerusalem Now.

"I love Sister Margaret," said Azraa Sahi, 29, a recovering addict. "She gives us a foundation we never had before."

"Sister Margaret has helped me look at life differently," said Raymond Walters, 51, who has been in the program for more than a year. "She's such a good person. She loves helping people. She loves people, period."

A hermit who loves people, and whom people clearly love. Imagine that.

Changing of Guard: A sober Chris Herren set for post-hoops life

The 33-year-old's hopes of returning to the NBA or playing pro basketball anywhere in world are now basically dead. With his Massachusetts driver's license expected to be suspended soon, the Fall River hoop legend had to give up his job repossessing cars recently and is seeking employment in tough economic times. And the ex-Celtics point guard also has a wife and three kids to support.

But considering the long fight that a now-sober Chris Herren is winning over alcohol and drugs, his current issues are far from the end of the world.

"I've been to hell and back," said Herren. "I lived the life that most people, a lot of people, don't get a chance to come out of, straight up. By the grace of God and the help from a plethora of people, I was able to come out of this.

"My financial situation is today. For today, it's fine. Am I comfortable and happy with it? Do I aspire for more? Absolutely. But like I said, from where I've been, it's a lot better."

Herren's hard fall from hoop legend to addict started when he was at Durfee High School in Fall River.

He averaged 27 points, 9 rebounds, and 8 assists as a senior in the 1993-94 season. The 1994 Massachusetts Player of the Year once scored 63 points - still a record - in an AAU game for the Boston Amateur Basketball Club.

Herren, a 6-foot-3-inch combo guard, was a McDonald's All-American and the focus of a book, "Fall River Dreams." He was featured in Sports Illustrated and mentioned in the same breath as prized Georgetown recruit Allen Iverson.

Through it all, Herren lived in a family that he says wasn't "Leave It To Beaver," but wasn't bad, either.

Celtics assistant executive director of basketball operations Leo Papile, who coached Herren with the BABC, said, "At his position in that era, in 1993 and 1994, there was no one better in the nation in high school as a combo guard. He could run a team, tough as nails, shoot the long ball, he had great instincts and feel for the game. He could run pick-and-rolls. He had an NBA résumé."

Said Herren, "What do you think your ego is going to be when you're a McDonald's All-American and you're in Sports Illustrated and Rolling Stone magazine and you have a book written about you? Your ego can go a lot of ways."

Herren opted to go 35 miles up Route 24, signing a letter-of-intent with Boston College. But his Eagles career ended shortly after it started as he suffered a season-ending broken wrist in his debut against Cal Poly-San Luis Obispo Nov. 25, 1994.

"BC was a good idea," said Papile. "But when he got hurt, it went up in smoke."

Herren partied hard and began using cocaine. His academics suffered. A substance-abuse counselor, who requested anonymity, said Herren's father approached him about helping his son with his drug problem. After three visits, Herren stopped meeting with the counselor, one whom he would cross paths with again 14 years later.

"The one thing that struck me about him when I met him, and this is not for everyone, but I liked him," the counselor said. "He was positive even when he fired me. He said, 'You're good at what you do.'

"He had no interest in pursuing counseling. That's typical with addiction."

Said Herren, "At 19 years old, I had the blinders on and I wasn't really looking for support, help."

After academic troubles and a failed drug test, Herren decided in April 1995 to transfer. Looking back, he wishes he had stayed in Chestnut Hill.

"Today, as an adult and a grown man, you value things a lot differently," Herren said. "You become a little wiser. The education you receive at Boston College is like no other, the network, the people you deal with."

Herren's next move was 3,000 miles west to play for renowned coach Jerry Tarkanian at Fresno State. After sitting out a season, Herren was eligible to play as a sophomore in 1996-97. Tarkanian believed Herren was one of the most talented guards he ever coached - even better than his Bulldogs teammate, Rafer Alston, now with the Orlando Magic. But the focus to become great wasn't there for Herren.

"He was very talented, no question about it," Tarkanian said. "He had great guard speed. He was a quick guard. He was better than Rafer at that time. But Rafer was the first one in the gym and the last one out. Chris had other things he was interested in."

One of Herren's most memorable games was when he scored 19 points in 30 minutes against the University of Massachusetts on Nov. 22, 1997. Three days later, he held a teary-eyed press conference in which he admitted to having an alcohol and drug problem. On Nov. 28, Herren departed for a three-week stint at a rehabilitation clinic in Utah.

Tarkanian said he had no clue about Herren's alcohol and drug problem, but he said Herren often had friends in town from Fall River, and they might have been a bad influence.

"I was shocked when he tested positive for drugs and had to leave the team," Tarkanian said. "After the UMass game, his father and grandfather were so happy. The following day, he tested positive. I was shocked. I was disappointed."

Said Herren, "I'd be partying for two or three days, then walk in to play UMass on an hour sleep on national TV."

Herren averaged 7.2 assists a game, second in the nation, during his senior year at Fresno State, as well as 11.4 points. Prior to the 1999 NBA draft, Suns guard Steve Nash, who was a friend of Herren, approached then-Pacers forward Chris Mullin about helping Herren with his off-the-court problems. Mullin, who had overcome alcoholism himself, obliged. Herren spent time with Mullin in Indianapolis working out and talking about his off-the-court struggles.

"He stayed in Indiana for a few days," said Mullin. "He got to meet my wife. He kind of got to meet the family. He ate meals with us. We shared some things. My wife knew who he was before and liked him. How many times does someone hand you a card and you don't call? We stayed in contact here and there after that."

With the off-court issues hanging over him, Herren fell to the second round and was selected 33d overall by the Denver Nuggets. He averaged 3.1 points and 2.5 assists while shooting 35.8 percent from 3-point range as a rookie in 45 games during the 1999-2000 season.

Herren seemed to be on the right path in Denver until he was introduced to the pain-relieving drug OxyContin.

"If you look at those pills, they're the size of an Advil and they come in pink, yellow, green, blue," Herren said. "How could these things harm you? How could they cause such destruction? But the pain that those little pills bring, I wouldn't wish that on anybody.

"And from that point, when I got traded, I didn't play many games sober. And if I was sober, I wasn't feeling good."

The Nuggets traded Herren and Bryant Stith to the Celtics for Calbert Cheaney and Robert Pack on Oct. 16, 2000. In his last NBA season, 2000-01, Herren averaged 3.3 points and 2.2 assists. The Celtics cut him Oct. 28, 2001, to sign veteran guard Erick Strickland.

Playing career ends

With his addiction to OxyContin in full swing, Herren became a journeyman player, making stops in Italy, Turkey, China, and Germany. He thought he could hide his problem overseas, but it got worse, and he says he began using heroin in 2004. He was even put in jail in China after being arrested in a bar fight.

His wife, Heather, never saw her husband do drugs, but she knew something was wrong as money issues cropped up. She began realizing her husband had a problem while he was playing in Turkey during the 2001-02 season, but she admitted she had a "lot of denial."

"When we got back from Turkey, I realized it was a big issue," she said. "It was a big, big issue that I never fathomed. I didn't know a lot about addiction."

Herren's playing career ended in December 2004 after he was cut by the Dakota Wizards of the Continental Basketball Association following an arrest in Portsmouth, R.I. Police found him unconscious at a Dunkin' Donuts drive-thru with 18 packets containing heroin residue, along with drug paraphernalia.

Herren blames no one but himself for his drug problems.

"The reality is, I've lived in seven different foreign countries and six different American cities and I found drugs in all of them," Herren said. "So it's not where you live, it's the person that you're bringing there.

"I did plenty of geographical changes in my life, thinking, 'I'm going to go to Italy to get away.' But Chris Herren was still with Chris Herren at the end of the day."

Hours before the incident in Portsmouth, Papile said, he had a bad feeling about Herren after watching him work out at the Celtics' practice facility in Waltham.

"I smelled a rat," said Papile. "It's not good with this kid. He was always a hyper kid, always over the edge. But this time he was going too fast."

Big assist for Mullin

As odd as it sounds, Herren's life finally changed for the better on June 4, 2008, when he was still a heroin user and heavy vodka drinker. He was found unconscious over the wheel of his car after it crashed into a telephone pole in Fall River, with a bag of heroin on the passenger seat.

He was taken by ambulance to Charlton Memorial Hospital in Fall River for treatment and turned to his cellphone in hopes of finding someone to call for help.

"I looked at my phone and I had no friends left," Herren said. "All I had in my cell phone were people you don't call to be there when you need them except my brother's phone number and I was too ashamed to call my wife. I called my brother and told him what happened. Then I started crying.

"I was in the emergency room and this lady, her name was Mrs. Roy, she said, 'I know your mom. I was friends with your mom and we are going to get you some help because you don't need to be walking out of this emergency room by yourself and try to figure this out.' "

Upon his release four days later, Herren went to a nearby detoxification facility. Mullin and his wife, Liz, read about Herren's incident in a California newspaper and reached out to him. The Mullins sent Herren to a residential drug rehabilitation program in Rhinebeck, N.Y., where he was without outside contact from June through August of last year.

"People that go there, it's real, real hard-core," said Mullin. "Like a lot of things, it's nice for people to help each other. But doing that helped me. In life in general, the more you give away, the more you get back."

Said Papile, "Chris Mullin is a saint."

Through it all, Heather stayed by her husband's side.

"I remember being really scared," she said. "I know he was. I really didn't know what the future would hold. There were times when I'd had it. I didn't know if I'd continue to support him. We were both really scared.

"But [June 4, 2008] was a significant day," said Heather. "No more deceit. No more lies. It was needed for him to be fine."

Next up for Herren was a three-month stint at the Miller House, a 33-bed residential program housed in a Victorian manor in Falmouth. There Herren met up again with the counselor he turned down in 1994.

"I was pleased he was getting serious," the counselor said. "I've been doing this a long time. It's not a surprise to see someone from 15-20 years earlier. His story is not unusual except for his background. He pretty much lost everything except his wife."

The counselor said Herren was serious from the moment he got there and showed the kind of leadership he did in his days as a star point guard. Upon Herren's departure last November, many of the other patients were happy for him but sad to see him go.

"Miller House was the best thing I ever did," Herren said. "It gave me the confidence that I could go on in life."

"Nothing made me more happy than to hear the peace in his voice," said his wife.

'Out of the darkness'

Herren spent a month in a Falmouth halfway house before going back to his wife and three kids. He departed a new man, drug-free since the incident on June 4, 2008, and alcohol-free since Aug. 1, 2008. He attends a one-hour rehabilitation program daily and counsels people trying to overcome addiction. He hopes to start a basketball school for kids in the Portsmouth area.

"Today, I've done everything necessary to feel sober," Herren said. "That's how I look at it. Do wounds heal? Yes, absolutely. Do I feel the guilt, the shame, the resentment like I used to? Not even close. I'm much healthier today because I put the work in."

Said Heather, "We are both finally out of the darkness."

Before this year's playoffs, Papile and Celtics scout Austin Ainge invited Herren and his 10-year-old son, Christopher Jr., to a Celtics practice in Waltham. After rubbing elbows with Celtics Paul Pierce, Ray Allen, Eddie House, and Stephon Marbury, Christopher went home with a wide smile and an autographed pair of Pierce Nikes, proud to be the son of a former Celtic.

"My son was on Cloud 9," Herren said. "For Paul to take the time out, for Ray to take the time out, for Stephon, Eddie House, for my son's sake . . .

"I don't need to validate anything. But for my kid growing up knowing that his father used to be a Celtic, and he had a chance to see that it was real. It wasn't just on the Internet and it wasn't just on trading cards.

"And when Paul handed him the shoes with, 'To lil' Chris,' when my son walked away, it was priceless. That's the thing. There are bad memories, real bad memories. But over the last year, there have been good ones."