Memories

I am surprised when, although it has been over four years since our son died of a heroin overdose, memories surface and grief follows. The surprise comes because the memories seem to come ‘out of the blue’, from no particular trigger and for no particular reason.

My husband just had a memory that was triggered when he heard our seven year old granddaughter express trepidation over seeing a bird that had died and fallen into the back yard. It was as if our son was seven again, full of wonder and normal childhood fears. His voice, his emotions, him.

I have had memories of our son as I’ve been working in our daughter’s garden or driving to the grocery store. JL as a young adult, just his face in some everyday interaction, triggering the sadness that he is no longer on this earth, part of our life, living the life that most 29 year olds are living.

It seems that memories don’t need a reason to rise to the surface from out of our hearts. Our son has been in our hearts since the day he was born and he continues to live there. It is the strongest ‘evidence’ we have that life does not stop after we die and physically leave the land of the living. We are eternal beings and I am very thankful for that.

WITH or WITHOUT HOPE?

There is something unique about the Christmas season, even if you do not buy into the Biblical story that lies at its core, even if you hold some other faith, even with no faith at all. For some reason, and not coincidentally, this time of year usually brings a sense of hope to most of us: hope in a better future for us and our loved ones, for society, for the world.

I think it is also tied in with the advent of a New Year, a new beginning, a chance to make changes that need a special impetus. “Hope smiles from the threshold of the year to come, whispering, ‘It will be happier’.” (Tennyson). It seems “Hope springs eternal in the human breast” (Pope) and as we stand at the starting line on the path of a new year, we are forward-focused with possibilities, even unlikely ones.

Hope is optimistic. Hope creates courage. Hope fosters healing. Hope dispels fear. Hope supplies fortitude and persistence. Blind Helen Keller said, “Optimism is the faith that leads to achievement. Nothing can be done without hope and confidence.”

But what about those among us – our family, our friends, even our selves – who see no hope for the future, feel no sense of expectation but instead see only more of the drudgery they have lived with in life, the continual uphill climb with no rest along the way, no way out of an unbearable situation? A relationship, prison, an addiction, an illness, poverty, a loss. I think we all know that for these discouraged and depressed ones this week, among all weeks of the year, is the final straw. Everyone seems happy and contented, planning new goals, possible changes, new adventures – everyone except them, except “me”.

Eight months before our son’s death, he saw a friend overdose and die during the holidays. It was the impetus for him to seek help and go through withdrawals from heroin one more time with the hope that he would be free forever from his addiction. It was a realistic hope – if we had understood what he knew: he needed medication to help him achieve that long-term goal. We had hopes but they were based on mis-information and faulty assumptions. Eight months later we realized our mistake.

If you are among those who feel no hope, who are facing unbearable situations, seemingly unbeatable odds, please remember that we all – ALL – need help at times with feeling hope-full. Take the one step that can help you find the hope you need to envision a different, better future for yourself: call someone or go somewhere. A friend, a help-line, a hospital, a 12-Step meeting, a church service. Reject feelings of shame at admitting you need help by remember that we ALL need help to make it through this life. We were never meant to live life alone. We ALL need the support of a community of some sort. Advocate for yourself – you are worth it – until you find someone who will help. And don’t forget God. His children throughout the millennia have felt despair and depression. But we can remind ourselves of what King David said: “Why are you in despair, my soul? Hope in God, my help, my God.” (Psalm 43:5)

And for those of us who are feeling the anticipation of a new year with new hopes and realistic expectations, let’s be intentionally on the look out for those whose hope is lost and who need a listening ear and a helping hand. Let’s use our blessed life to help someone else.

Woman of Substances

In 1979, the novel A Woman of Substance was published. It was the first in a series of seven portraying the substances and schemes, the means and maneuvers of three generations of a retail empire. Being “a woman of substance” is considered a great compliment for a woman who aspires to be influential, a woman of power, a positive influence. 

In a clever spin on this phrase, journalist and author Jenny Valentish has written Woman of Substances. I picked it up last year while in Melbourne, Australia and I couldn’t put it down. Her narrative flair for relaying her personal experiences while presenting scientific findings on addictions of all  sorts is extremely engaging for women – and men.

Jenny’s nutshell:

A girl falls down a rabbit hole. She obeys every ‘drink me’, ‘eat me’ prompt and meets all sorts of freaky characters. Chaos ensues. Then she wakes up and exploits her position as a journalist to ask experts what that was all about.

Although it is not a memoir per se, her blatant honesty and self-deprecation about her past and her choices is revealing, while not glamorizing the depths to which her addictions took her. She interviewed 35 clinicians, counsellors, doctors and academics about their fields of expertise and shares her personal experiences of her up and down road to recovery and sobriety.

The chapters cover: The roles of temperament and impulsivity in addiction. Hitching adolescent identity to substances. Internalized misogyny as a contributing factor. The relationship between substance use, eating disorders and self-harm. Sexual assault and spiking. The impact of childhood trauma on the brain and behavior. Related foibles, such as gambling, theft, compulsive buying and compulsive sexual behavior. Self-medicating mental illness and PTSD. AA and other forms of treatment. The ways in which research and treatment is geared towards the male experience.

My husband, daughter, and I had the privilege of meeting with Jenny for lunch in Melbourne last week. She is as real in person as she is in print. We discussed current trends of drug addiction in Australia along with recovery and family help groups she is connected with.

What reviewers are saying:

“Raw, revealing, at times heartbreaking, but searingly honest and aimed to support anyone who is wondering if they will ever recover from addiction.”

“This book taught me things I wasn’t expecting about the landscape of substance use. You don’t have to be a spectacular comet of crazy like the young Valentish to find something of yourself in these pages. I can’t imagine there isn’t a young person, friend or parent who won’t get something important from reading this book.”

“Like a tour guide in a foreign land, Valentish waves a flag and provides a path back from the abyss. This is an enormously compelling, confronting and informative piece on addiction and recovery from a female perspective.”

Ultimately, Jenny show us that being a Woman of Substances keeps you from being influential, powerful, and a positive influence. As we told her, we are proud of her determination to truthfully relay her failures and her persistence in walking the uphill road to wellness and freedom. They will assure her place as a powerful and positive influence on this generation.

www.womanofsubstances.com

You can purchase Woman of Substances on Amazon or at your local bookseller.

Change Our Way of Thinking

In the 1970’s, Bob Dylan sang: “We’ve got to change our way of thinking, make ourselves a different set of rules…”

I thought about this song recently as I remember how differently we, as parents of an opiate/heroin user, thought a decade ago. We thought, and were taught, that if our son just worked the 12-Steps hard enough he could gain lasting sobriety.

We had an abrupt and jolting wake up call on August 2nd, 2014. And what we have learned since our son’s death is that it’s just not that simple. Yes, there are opiate addicts – better, those with Substance Use Disorder – who have survived this deadly addiction without Medication Assisted Treatment (MAT), but they are few and far between. And they did not achieve sobriety with one attempt.

Last week,I heard an update on the current Ebola outbreak in the Congo. Two hundred people have died already and those fighting the battle are using every resource possible to contain it. It is terrible.

What if we treated the opioid epidemic with the same urgency and resources?

A sheriff in a county near Seattle had a similar epiphany last year after he was elected sheriff. He toured the jail and and saw it had become a de facto detox center full of very, very sick people. TY Trenary said: “Detoxing from heroin is like having the worst possible stomach virus you can have. People are proned out, just suffering.”

Last year, leaders declared the opioid epidemic a life-threatening emergency. The county is now responding to the drug crisis as if it were a natural disaster, the same way it would mobilize to respond to a landslide or flu pandemic.

The county’s program includes small steps, like making transportation easier for people in drug treatment. They train family members and others in the community on steps to reverse overdoses with medicine, and they send teams of police officers and social workers to help addicted homeless people.

The new approach is paying off. The teams have helped hundreds of people find housing and drug treatment.

I have changed my way of thinking – how about you?

https://www.npr.org/sections/health-shots/2018/10/28/658476111/a-rural-community-decided-to-treat-its-opioid-problem-like-a-natural-disaster%20?utm_source=npr_newsletter&utm_medium=email&utm_content=20181104&utm_campaign=&utm_term=

No Magic Bullets

Last week here in Tucson, Arizona, some young people were together at a house using heroin. They were unaware it was laced with fentanyl. Friends ran to a nearby restaurant and flagged down police to help one person who was unresponsive from an overdose. He was revived with Narcan (naloxone). The officers were then taken to the house where six others had overdosed. One 19-yr old did not make it. Tucson Police all carry naloxone because they are usually the “first responders” to victims of overdose. Sadly, our Pima County Sheriff officers do not carry it – with the line of reasoning being that it is too costly for the training and they are not usually the first responders.

Naloxone (Narcan, Evzio, injectable or intranasal spray) was patented in 1961, and is an opioid antagonist—meaning that it binds to opioid receptors and can reverse and block the effects of other opioids by displacing them from the opioid receptor sites in the brain. Whereas an agonist causes an action, an antagonist blocks the action of the agonist. It has been used in hospital “code arrest” emergency situations for decades. It is being carried by emergency personnel and families of addicts because it can very quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain medications.

But it is not a magic bullet. Statistically, most opioid overdoses happen when the user is alone. By the time they are found, usually many hours later, it is too late for resuscitation. Another reason is that public safety experts are concerned, and rightly so, because addicts may be less motivated to find a way to quit using opioids since they can be revived. Their family and friends will also feel less anxiety and less concerned about urging their addict to get long term help. A recent news special interviewed several opiate addicts who had been revived multiple times with naloxone. One was an older man who is a “career addict”. He has no real desire to get clean and carries naloxone in case any of his friends need it. The other was a young woman who had overdosed and been revived several times and had finally gone through a recovery program and is clean and sober. She is very thankful for the times she did not die because finally, finally she was able to get to the point where she wanted to leave her miserable life of addiction and be free. But let’s remember: she needed a recovery program option. We cannot just turn those addicted to opioids back onto the streets after reviving them.

She is an example of the recent statistics that it takes on average 10-12 recovery attempts before an opiate addict can stay clean and sober long-term. Ten to twelve. It is a fact that relates to the addictive quality of opioids. For many of those addicted to opiates, those 10-12 attempts will never happen without overdoses and then being revived with naloxone. We, as a society, must be willing to offer this chance to those who are trapped by addiction to substances that have poured onto our streets and into our schools at an unprecedented rate. Our son went through several recovery programs and was at the point of really wanting to be free of his addiction. But without the needed medication, such as Suboxone, his last relapse proved fatal. He died of a heroin overdose at 25 yrs old – alone. There was no magic bullet for him.

STIGMA, Part 2: How to Remove Stigma

Although name-calling is childish and something most parents teach our kids to not do––even when provoked––it’s surprising how many families use it as a weapon and carry its poison into adulthood. The name-calling and negative labeling we have been subjected to from prominent political leaders in the past few years must have been learned at home and seems effective with others who are similarly immature. I was raised with the saying, “Sticks and stones may break my bones, but words will never hurt me” as a way to deflect hurtful, shaming words. As I came to realize when I grew up, it is the farthest thing from true. Negative labels stick like glue to our hearts and souls, and for those struggling with addiction and alcoholism, come to define them––especially to themselves.

When words are dismissive and disdainful they telegraph judgment of addiction as a moral failure, chosen and desired, for which a person deserves to be shamed. Let’s change our vocabulary with true words that describe addiction for what it is: a chronic disease of the brain. Change the inaccurate and stigmatized word “abuse” to “substance-use disorder”: a health issue that can be treated successfully with medication, group involvement and support, and therapy.

Hazelden says their “fundamental addiction stigma-smashing strategy is to shine a light on people who are in recovery and expose the reality that people actually do recover from addiction; that it’s a chronic disease that can be successfully managed for life; and that it affects individuals who are every bit as moral, productive, intelligent, talented—and humanly flawed—as the next person.” That means you and me.

Also, educating health care professionals is very important as they work on the front lines in many areas: in prescribing medications and monitoring patients more closely in order to get them the right help as early as possible. They need the basic knowledge to recognize substance use disorders, understanding the complexity of the disease and the recovery process. Statistics show that physicians are still over-prescribing opiate pain medications, especially after accidents and surgeries, and not making use of physical therapy for pain management. In Dr. Jana Burson’s blog about stigma she cites one doctor who is pro-stigma, saying is “a good thing because stigma discourages deviant behavior and has a civilizing effect on society… and people with substance use disorders are irresponsible.” This doctor said of people who relapse back to drug use repeatedly “it is a behavior almost always under one’s control…” Dr. Burson says, “Loss of control over substance use is one of the hallmark criteria for the diagnosis of substance use disorder.” See her blog for the remainder of this important discussion.

https://janaburson.wordpress.com/2018/07/16/stigma-and-substance-use-disorders/

And prevention. This is the best weapon we have to fight against the epidemic that is taking the lives of over 70,000 mostly young people every year in our country. Trying to stop the immoral manufacturers of addictive drugs in illicit labs in China and Mexico––and by big Pharma in US––is a lofty goal and worth continued effort. But those drugs would have limited consumers if we focus our attention on clearly and openly teaching our children about drug and alcohol addiction from an early age and continuing the dialogue as they mature and experiment. And yes, even as some of our own children become the the 20% who find that, among all of their friends that try the same drugs at a party, they are the ones who can’t just walk away, they would know they can come to us without shame and stigma and ask for help.
The AMA and Am. Society of Addiction Medicine (ASAM) have a good article on stigma:
https://www.asam.org/resources/publications/magazine/read/article/2015/12/15/patients-with-a-substance-use-disorder-need-treatment—not-stigma

STIGMA, Part 1: What and Why

In the Greek and Latin worlds, a stigma was a mark or brand, especially for a slave, identifying the person as “inferior”. When stigma began to be used in English, it meant the kind of mark or stain you can’t actually see. (Merriam-Webster). Social stigmas are based on perceivable characteristics, associated with certain behaviors that distinguish a person from other members of society. They convey disapproval and disgrace. Dis-approval. Non-approval. Dis-grace. Non-grace. Being dissed.

In an article on The Stigma of Addiction from Hazelden Recovery we learn: “The stigma of addiction stems from behavioral symptoms of substance use disorder… impaired judgment or erratic behavior, which can result in negative consequences including legal, occupational and relationship problems. Understandably, these consequences cause embarrassment and shame among those affected. They also create stigmatized attitudes and perceptions among the wider public, a response that perpetuates and exacerbates the private shame associated with drug addiction.For generations, this combination of personal shame and public stigma has produced tremendous obstacles to addressing the problem of alcoholism and addiction. Today, the stigma of addiction is seen as a primary barrier to effective addiction prevention, treatment and recovery efforts at the individual, family, societal levels. Addiction stigma prevents too many people from getting the help they need.” The article goes on to discuss the irony that many of these stigmatizing behaviors diminish and/or disappear when a person is appropriately treated in recovery.

In my family, and in most others, alcohol and drug addiction is considered private, and “is something only whispered about. Even when the symptoms of the disease are obvious to all around, individuals and families avoid seeking help for fear of even acknowledging the problem. This is one reason only one in 10 Americans with a substance use disorder receives professional care.” (ibid.) When talking recently with some of our son’s friends and former addicts, they are unwilling to let their past drug use become public knowledge because of the potential negative repercussions they justifiably fear in their careers and relationships. What does this say about us as individuals, communities, employers, and society in general?

Hazeldon, with almost 60 years experience treating alcohol and addiction, says “the same undercurrent of addiction stigma keeps addiction under-diagnosed, under-treated, under-funded and misunderstood by many, especially as compared to other chronic health conditions such as heart disease, asthma and diabetes.” Why? The individual is seen as having a moral failure instead of a health problem. I have an anecdote I share with people when we discuss addiction. When I have been given oral opiates when leaving the hospital after surgery, I take one or two and then opt for the pain because I hate the way they make me feel: disoriented, unable to sleep deeply, and not myself. My husband recently had surgery that he was warned would be painful for 4-6 weeks following the procedure. That was an understatement. He was given a prescription for 10 days of opiates. We thought that would be unnecessary. We were wrong. When he was taking the pain meds as prescribed, he was his normal, cheerful self – it was like magic. As soon as they wore off, he was cranky. Of course he was in pain, but it was more than that. Why?

For us, it’s not difficult to understand. He has the “addiction” gene, as we call it. There were alcoholics in both of our mothers’ families. He got the gene that I seemed to have dodged. Did he ask to have that gene passed down to him? Did he decide he would feel good taking opiates for pain? Of course not. And neither did our son. Nobody makes the decision on how their brain will react to different substances. It happens. The issue is what a person does once they know that a mind-altering substance spells “pleasure” to them? Do they keep a safe distance from it as John has done or do they play with fire? For parents with addiction in our family trees, prevention is our best and most powerful weapon. Two books to aid parents in prevention are:
The Teen Formula : A Parent’s Guide to Helping Your Child Avoid Substance Abuse By  Dr Dave Campbell and Drug-Proof Your Kids by Arteburn and Burns.

Had we known then – when our son was an adolescent – what we know now, we would have made significantly different decisions regarding our attitude towards pain medications, drugs, and alcohol – and especially begun discussing addiction in general and in our family in specific. I believe our son would still be alive if we had.

https://www.hazeldenbettyford.org/recovery-advocacy/stigma-of-addiction