The pervasiveness of opioid addiction was made clear to my husband and I, once again, on a recent trip. We were in California at one of our favorite Italian restaurants having a chat with one of the owners – catching up after not seeing each other for a few years. Somehow, yet very common for us, the conversation turned to the opioid epidemic and our son’s death from overdose. Our friend remembered us telling him about it, paused, and asked: “Do you mind if I tell you a personal story about heroin?”
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.
My husband and I just returned from a wonder-full vacation in Europe. We felt privileged and blessed in every way. Although we were enjoying our new experiences together, our son’s death from a heroin overdose was never far below the surface. We carry a lingering pain, knowing that although we tried our best to help our son, the three of us could never seem to find our way through the maze of dead ends and wrong turns for the right treatment for his increasing dependence on the substance that would eventually take his life.
While we were in the Netherlands, my husband, a pharmaceutical scientist, was contacted by a client and asked to analyze data from a drug study that was being conducted 15 minutes away from where we were. The human study, in those with opioid addiction and the control group without, is searching for a better medical approach to help addicts when they want to become clean and sober.
Half a world away from home we were reminded of people struggling with opioid addiction. And half a world away, there is still shame and stigma attached to being an addict, and there are parents, families, and friends living with the pain of watching someone they love not actually living life but hanging on from day to day, never knowing when their loved one will be another statistic in the world-wide epidemic in which there are few viable options for help.
The ongoing opioid crisis has drawn attention to the widening gap between the high need and limited access to substance use treatment in the United States. A recent Substance Abuse and Mental Health Services Administration report found that of 21.7 million Americans in need of substance use disorder treatment, only 2.35 million received treatment at a specialty facility. This led to a new study recently published in the Journal of Addiction Medicine, where several researchers and physicians searched for the predominant barriers for addicts receiving treatment (https://scienmag.com/study-looks-at-barriers-to-getting-treatment-for-substance-use-disorders).
Four broad themes were identified:
Patient Eligibility – Difficulties in determining patient eligibility for a particular and appropriate treatment center.
Treatment Capacity – Even if a patient is eligible, providers have trouble finding out whether space is available.
Knowledge of Treatment Options – Health care providers may not understand the levels of available and appropriate care for substance use treatment.
Communication – Difficulties in communication between referring providers and treatment facilities contribute to delays to starting treatment. The need for direct referral – “from the emergency department to a bed” – is particularly high for patients with opioid use disorders.
“Access to substance use disorder treatment is often a maze that can be difficult to navigate for both providers and patients,” Dr. Blevins and coauthors write. Yes, and it was even more so for those of us who found our teenager using heroin in the early 2000’s. No one was talking, our doctors had no experience with opioid addiction, treatment options were extremely hard to find and expensive, and for many of us, not covered by insurance.
For those of us who tried so hard to maneuver our way through the maze, we continue to live with the pain from feeling that we failed our son in a million different ways, while we tried so hard to get it right. May our being open about our experiences help those of you still living a tension-filled life find the answers you need to get you through the maze quickly so there may be a different outcome for you or your loved one.
What does the acronym HALT mean? And why is it an important part of a recovery plan? Hungry, Angry, Lonely, Tired: these are warning signs, red flags. HALT is a tool to remind us to stop – halt – and take a moment to listen to what our emotions and body are telling us.
I am not an alcoholic or addict – you may not be either. So why did I use ‘us’ as I wrote this blog? Because all of us are subject to these basic needs – human needs – and if they are not met, we will instinctively search until we find a way to have them fulfilled. Our responses may not be as self-destructive as an addict or alcoholic, but they will affect our relationships in one way or another. Let’s be careful to not make such a wide differentiation between addicts / alcoholics and us: the ‘us vs them’ mentality that makes ‘us’ superior and ‘them’ inferior.
Hungry. This can be physical, emotional, or spiritual hunger. Physical hunger is fairly easy to satisfy, but for many addicts, getting nutritional meals can be a struggle. Yet it is still easier than getting the affection and understanding that is even more vital to our well-being. This is why a strong support system is so important – and must already be in place before a time of need. Attending meetings is good, but being part of a small group is even more critical.
Angry. This is a normal human emotion. The key is to self-assess and decide why we are angry and what we can do about it. If the issue is out of our control or we aren’t ready to confront it, we look for other ways to release the anger. Exercising, meditation and prayer, and creative outlets can help, as is having a trusted friend or counselor to discuss our feelings with. Whatever we do, denying or repressing anger will not be healthy for us long term.
Lonely: We can be lonely in a crowd or in our room. It is a sense of being isolated, not understood, not appreciated, fearful. Withdrawing feels safe when we are overwhelmed or anxious, but for many addicts it can lead to relapse. I will never forget a conversation with our son when he said “I hate being alone”. I was shocked because he had always been more of an introvert than our daughter. But once he was addicted to opioids, I think the isolation that occurs while using became like prison to him. Perhaps it made him feel less ‘normal’, which he wanted so badly to be. A healthy relationship where we feel safe reaching out to in times of need will make all the difference.
Tired: We all get out of sorts when we are tired. When our lives are filled with activities such as work, school, family, meetings, our need for rest gets pushed to the side. But it is not healthy for us physically, spiritually, or emotionally and it affects our ability to reason and cope with difficulties. Relapse is just around the corner unless our body and mind are restored. It may be hard and uncomfortable to say we need a break to get some sleep, but it will benefit us and it is critical to maintaining sobriety.
Self-awareness and self-care are not self-ish, as many of us were taught when we were growing up. They are vital steps to help maintain a life on the path of recovery and will not only benefit us, but all our relationships.