On March 10th, our son would have been celebrating his 33rd birthday. That day is now a painful reminder of all the potentials and possibilities that a young person should be experiencing in the 4th decade of their life.
After JL died of a heroin overdose in 2014, I began the dreaded process of sorting through his belongings – which included his computer and phone. Many of the photos on his phone I had never seen and some have now become permanently seared into my visual memory. One is of JL with a Boa wrapped around his shoulders and neck.
Boas are constrictors. Constrictors don’t chase their prey. They are ambush hunters. A boa grabs its prey with its teeth, then quickly coils its body around the prey and squeezes. It doesn’t break the bones – it constricts so tightly that its prey can’t breathe. With each exhale, it tightens its coils until its prey dies slowly from an overwhelmed circulatory system due to blood not getting to the brain. Once dead, the snake swallows its prey whole.
(Translation into most languages at tab to the right.)
A few months ago, John was on a phone call with a physician who was asking his input about a new drug to help with opioid addiction. John shared about our son’s addiction and death and how we hoped that by speaking openly about his life and writing our book and blog we could help in some small way. His response was something I did not expect and will never forget. He said, “Don’t underestimate advocacy because it is the surest way to change things. Science and medicine take a long time and have limited effectiveness.”
An advocate is someone who works by speaking, acting, or writing truthfully on behalf of a person or group in order to promote, protect, and defend their welfare and to seek justice for their rights. To speak out for those who have no voice. But advocacy is not cheerleading. A cheerleader is someone who only supports their team or player – since they are in competition against another team. They are indiscriminate about what their team does or doesn’t do. They don’t necessarily look at the big picture or causes and effects. Their role is to simply cheer on their team or player and boost support from their fans with slogans that may or may not be true.
Serious problems that affect the wellbeing of individuals, communities, and entire societies, such as the Covid-19 pandemic, addictions, and racial prejudice and inequality, are not helped by cheerleading. People in danger and suffering need advocates who have compassion, who are truth-tellers, and who will vigorously and untiringly work for a solution.
When I see a young person on the streets, homeless and struggling, enslaved to a substance that is stealing their life – or anyone living with addiction of any sort – I long to be helpful in a meaningful way and become discouraged at my inability to do so. And if I feel discouraged, how must they feel? What will help bring real, substantive change and hope to these lives and in these circumstances?
As parents of a son with a deadly addiction, we were sometimes cheerleaders when we needed to be advocates. Cheering him on and telling him he could do it without any medical help was not being realistic or being the advocates he needed. I think it is difficult to be an effective advocate for those we love because we are too close to have a clear perspective. Which is why a supportive recovery community – for both the family and the one struggling – is vital. We must try and use whatever resources we have: our voice for those who are not being heard, our writing to bring clarity to public thinking, our physical presence to stand or march with others, and our time, energy, and finances to step in where we can or offer help to find those resources.
There are as many ways to be an advocate as there are needs in this world. I have friends involved in racial justice, in refugee struggles, in stopping sexual exploitation and abuse, homelessness and poverty – the list is endless. The question is: How can each one of us be an advocate for the people and needs we are aware of and that we have a passion for?
It has been said thatthe opposite of addiction is not sobriety, it is connection – to others, to a community.The Coronavirus pandemic has brought disconnection and magnified loneliness and stress for people the world over due to social isolation, economic instability, reduced access to spiritual communities, and overall national anxiety and fear of the future. “We certainly have data from years of multiple studies showing that social isolation and social stress plays a significant role in relapse…relapsing to drug use can play a role in overdose.” Dr. Wilson Compton, deputy director NIDA.
The acronym HALT: Hungry, Angry, Lonely, Tired, is used in Alcoholics Anonymous and most recovery programs. It is a simple reminder that when our basic human needs are not met, one is susceptible to toxic thoughts and self-destructive behaviors including relapse and suicide.
Regardless of where you live, there have likely been restrictions imposed to limit the number of people who can gather together – from dozens in some countries to only the members of your immediate household in others – in order to slow down the high-speed train that is Covid-19. For many of us, we have been able to maintain our emotional equilibrium because we know this is for a limited time and we can look forward with hope to the future.
But what about those vulnerable members of society who already struggle on a daily basis with insecure housing and food supplies and to maintain their mental health, sobriety, or recovery? In the midst of one of the most isolating crises the modern world has known, it is no surprise then that cities across America, and around the world, are reporting dramatic increases in drug overdoses, alcohol relapses, and suicides.
In-person community meetings are at the foundation of recovery programs. And no wonder. It is in community where individuals become part of something greater than themselves. And I believe it is in the breakdown of communal life in individualistic American ideology that has, to a great degree, contributed to the anxiety, insecurity, and depression that so characterizes our national psyche and has led to the pursuit of finding relief in so many unhealthy ways.
A friend of our son who is an alcoholic who has been working his recovery for the past 8 years, put it this way:
“Self-isolation breeds relapse for people in recovery. With quarantine, people are losing the accountability they have relied on from in-person meetings and it’s a lot easier for people to further isolate and close off their emotions. Attending virtual meetings keeps me grounded and gets the message across as much as regular in-person meetings but lacks the fellowship aspect. This will no doubt expose many in recovery to loneliness.”
Even though increasing numbers of people around the world are vaccinated, it will not stop some of the isolation and loneliness. Is there anything those of us who are not isolated emotionally can do to help? The one thing my husband and I have made as a priority in our weekly schedule is to check in with friends around the world via texts, emails, letters, phone or video calls – including our young friends who are in recovery and elderly friends who just need to know they are not forgotten. With our social networks and finances, we can support organizations that are working the front lines to serve the addiction/mental health population. We can make or purchase masks, buy food and basic supplies, to give to those in need and support recovery programs in our area.
(Translation into most languages at tab to right.)
In the Greek and Roman worlds, a stigma was a tattoo or brand, especially for a slave, identifying the person as “inferior.” As stigma moved into English, it referred to a mark you couldn’t actually see but which was nonetheless powerful. 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.
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…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.” Yes, only one in 10 people struggling with addiction receive treatment. 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.
When talking recently with some of our son’s friends, they have been unwilling to let their past drug use become public knowledge because of the potential negative repercussions they justifiably fear in their careers and relationships. How much worse would it be if they were still living with addiction? What does this say about us as individuals, communities, employers, and society in general? When an individual is seen as having a moral failure instead of a chronic health condition, stigma is the logical result. But no one makes the decision about how their brain will react to a substance and whether they will become addicted after minimal use or hate how it makes them feel and never use it again.
Negative labels stick like glue to our hearts and soul and, for those struggling with addiction and alcoholism, the personal shame becomes how they define themselves. The public stigma that follows is the tattoo they never asked to have. If we can reject stigmatizing and instead provide a safe and listening ear to those struggling with addiction, inviting them to share their stories and encourage them to consider recovery options, they may be willing to join the many people who do learn to manage their disease and successfully recover. Let’s remember that they are just as valuable and able and worthy of love – and as human – as you and me.
Translation into most languages at tab to the right.
A few weeks ago, John and I were interviewed by Jeff Simone for his Surviving the OpioidEpidemic podcast (see YouTube link). We had a really great conversation about our family living with a teenage son with opioid addiction and how his death from overdose affected us and changed our lives. Jeff serves the addiction community with a coaching service called Reaction Recovery.
Here are some insights into his recovery approach.
Reaction Recovery is a private coaching service designed to help individuals thrive in their life of recovery from substance use disorders. It is a one to one, intensive behavioral approach to help individuals identify areas to make focused and intentional lifestyle modifications. Dr. Simone has been formally trained in clinical pharmaceutical and dietary supplementation advisory and management. He has earned degrees in nutrition, physiology, is a certified life coach, and has personally worked with over 200 people recovering from substance addictions.
Why ‘Reaction’ Recovery? Who is reacting and to what?
Reaction Recovery was started as a “reaction” to the current treatment approach to addiction. The medical community is doing a good job offering short-term acute care crisis management for addictive disorders, but are doing poorly offering long-term treatment for those who have become abstinent but not yet stabilized. This describes our son’s – and most others we know – situation perfectly. Addiction needs long-term care and support.
The basic coaching approach addresses the physiology of the addiction, post-acute withdrawal syndromes, nutritional interventions, dietary supplementation, and how this all can safely integrate with other pharmaceutical treatment strategies that might already be on board.
Based on what Dr. Simone has called the ’12 Daily Rules for Recovery,’ their coaching techniques will systematically and methodically help the individual identify specific areas to be adjusted and then develop individually tailored strategies to affect real change.
The 12 Rules focus on building up a support community – first and foremost – then developing a healthy and consistent morning routine, understanding the importance of full-day nutrition, ensuring the body is receiving all nutrients necessary to support a strong and optimal brain and body, establishing a safe and appropriate dietary supplement regimen, expanding the mind with helpful books and information, developing a realistic exercise routine, carefully auditing the external distractions in our lives, constructing a regular nighttime routine, and more.
When these considerations get repeated across thousands of iterations, and with a little guidance and accountability, they become a foundation upon which the rest of the individual’s recovery will be built. Eventually – through ruthless repetition – new neural pathways begin to form until eventually this life of abstinence doesn’t feel so difficult and a sustainable, meaningful recovery is able to take shape.
Jeff’s approach of community as essential and creating new, healthy habits to replace old, destructive ones has been the topic of several of my blogs (see below). Whatever habits we create will become automatic and will serve us and our life-goals well as we go through each day.
(Thirty-fifth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
This week’s Story of Hope is from a friend of JL’s, Peter (not his real name). Here are some excerpts from his story in Opiate Nation (5 min read):
My name is Peter and I’m an alcoholic and addict. This is how I introduce myself at the AA meetings I attend several times every week, as I have done for over 10 years. I am from a fairly affluent family, raised with high moral standards, and attended the best schools. So how is it that I became an alcoholic by the time I was a senior in high school and an opioid addict and dealer by the time I was 20?
The first time I used alcohol was in my junior year in high school. I was new to the school and I felt like I didn’t get the playbook for how to be a part of the group. I had been raised with strong values against using drugs and alcohol – but I wanted to fit in with the popular kids.
I tried a capful of vodka—that was it. I hated the way it tasted. The next day I was sick—not so much from the alcohol, but with guilt. This would be a consistent theme in my drinking and using: I always felt guilt and the consequences of doing something soul-crushing and bending the moral line I had deep within me. Once that barrier had been crossed, then anything was permissible. Initially I only drank on weekends at parties so that I wouldn’t be the outsider.
(Thirty-third in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
This week’s Story of Hope is from our son’s friend, Hank (not his real name). Here are some excerpts from his story in Opiate Nation (5 min read):
I grew up in a loving home – the youngest of seven kids in a Catholic family. Although there are no alcoholics in my immediate family, my mother’s side of the family consists of proud Irish New Yorkers where alcoholism runs rampant. I experienced my first drunk at the age of 13.
(Thirty-second in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
During the years since our son died, we have been encouraged and supported by his friends –many of whom have awe-inspiring recovery stories. We asked several of them to share their stories in Opiate Nationwith the hope that they will give insights for parents and encourage other young adults to know they can be sober and have a meaningful life full of joy, love, and hope.
What we learned from these stories – and from the many stories we have heard in recovery meetings, in the news, and in books – is that there are some common threads that run through the lives of people struggling with addictions. And although there are no formulas for raising kids who will not use drugs or abuse alcohol, becoming aware of the common threads and risk factors in families with addiction and alcoholism is a good place for parents to start. If these commonalities are understood and taken into consideration, they might help avert tragedies such as the one we experienced.
I have written about each of these threads in separate chapters of Opiate Nation, but I will summarize them here:
(Twenty-fourth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
Historically, “enabling” referred to facilitating or empowering someone in order to help them accomplish something. By teaching children to read, we enable them to develop their intellect and further their learning. Or, as in 1933 Germany, “The Enabling Act” gave Adolf Hitler the power to enact laws without the involvement of the legislative bodies: he was enabled to become a legal dictator. In modern psychology, enabling can be positive, but it is also used in a negative sense when it encourages dysfunctional, unhealthy behavior and habits, as it is used in addiction and recovery vocabulary. Rescuing and caretaking are terms that mean what they say. They are closely connected to enabling: we rescue people from their responsibilities and we take care of people’s responsibilities for them.
Melody Beattie (Codependent No More) refers to the “Drama Triangle” roles of victim, persecutor, rescuer, and says “Rescuing/caretaking looks like a much friendlier act than it is. It requires a victim who is actually capable of taking care of themselves even though we and they don’t admit it…After we rescue, we will inevitably move to the next corner of the triangle, persecutor. We become resentful and angry at the person we have so generously helped…Then we move to the victim corner of the triangle, at the bottom, the predictable and unavoidable result of a rescue.”
(Twenty-third in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
For generations, the combination of personal shame and public stigma has produced tremendous obstacles to addressing the problem of alcoholism and drug addiction in America. Addiction stigma prevents too many people from getting the help they need.–Hazelden-Betty Ford Institute for Recovery
Historically, the word shame was used interchangeably with guilt – the appropriate pang of conscience that followed doing something wrong. In reality, there is an important distinction between shame and guilt. Shame is about who you think you are; guilt is about what you have done.
Stigmas are linked to shame. In the Greek and Latin worlds, a stigma was a mark or brand, especially for a slave, identifying them as “inferior.” Later, it became known as a mark or stain we can’t see with our eyes: social stigmas that are based on perceivable characteristics, associated with certain behaviors that distinguish a person from other members of society. They convey disapproval and disgrace.
The Ohio Society of Addiction Medicine is a chapter of ASAM - A professional society actively seeking to define and expand the field of addiction medicine.
Opiate Nation 