Coming Out of the Black Hole

In doing further research in support of the upcoming publication of our memoir, I have found many new groups, websites, and blogs about the opioid epidemic. It is very encouraging. And I was thinking back to 2005 when we first discovered that our son was using Black Tar Heroin. We were in an absolute black hole of information––there was nothing to be found on the internet or in our community, even though it had been a decade since this new way of producing and marketing heroin had hit the streets of the west coast. Eventually we discovered Black Tar Heroin: The Dark End of the Street, a1999 documentary directed by Steven Okazaki. Filmed from 1995-98 in San Francisco.

As our son went through weeks of withdrawals without any medication, we finally found an outpatient recovery program for teenagers and their families in our town. (We had found inpatient programs that were in the $75-100K range, but that was beyond our resources.) Just a few weeks before we found out about our sons’ use, there had been a drug bust at his high school with many students who were using opioids sent away for rehab. What is sad and frustrating, still, is that no one––not school officials or the nurse or parents––no one let the rest of the school community know. No one shared information and I don’t think we have to wonder why.

The shame and stigma associated with having kids who use dangerous drugs is something that is still very much a taboo for many people. I continue to hear about young people who “died suddenly” but with no explanation of how. Sadly, we have learned from experience that 20-somethings do not die suddenly for no reason.

This makes the growing number of parents who are coming forward and sharing their stories worth celebrating––along with the many new organizations for helping families handle the complexities of addiction, detox, rehab, and recovery. All the awareness and action brings me hope to think that there will be fewer kids getting addicted in the first place and fewer families planning memorial services.

Here are just a few websites worth visiting and passing on, especially to anyone who has children starting with middle school age and up. It is never too soon for parents and their kids to be informed.

CRAFT PROGRAM: Community Reinforcement and Family Training  https://alliesinrecovery.net/about-craft/

Denial is a common theme among those suffering from addiction. If someone is regularly abusing alcohol, prescription drugs, or illicit substances, denial might have them convinced that there is no problem or that any problems are only the perceptions of their loved ones.  50% of people suffering from substance use disorder, and who admit they have a problem, are resistant to getting help. CRAFT was designed with these individuals in mind. Rather than target the person with addiction directly, CRAFT works with the concerned significant others so that they can assist the person to admit they have a problem and then seek help. It also helps show friends and family how to better communicate with their addicted loved ones.

Family Resource Center

http://www.familyresourcectr.org/
“Empowering families to understand and address a child’s substance use.”
Offers a variety of age-specific resources such as videos, articles, manuals, etc. to help understand what addiction is, who is susceptible, and the other long-term consequences associated with adolescent substance use. It can give you the resources you need to support your child before, during and after substance misuse begins.

https://humanizingaddiction.com/
“…a website that will introduce addiction to those not impacted in order to help prevent it from capturing a loved one and to bring awareness that the unthinkable is real. A place to share our love for ones that struggle to hopefully inspire others still fighting to come out from behind closed doors and to scream from the rooftops that our gracefully broken are the faces of those not aware that it can happen to them. A source that offers a private look into the day in a life of those captured by addiction. A site with personal journals of those that struggle against addiction each day.”

http://thealarmgroup.org/
“ALARM: A Living Amends Resource Media – The Voice of the Voiceless
To amend means to make a change.  We believe the epidemic proportion of the drug problem in the United States requires change, so we decided to act on creating the change we want to see. We’ve seen the raw results of this plague and couldn’t sit on the sidelines. It seemed like everyone we talked to knew or was related to someone who had died of an overdose or complications of opioid drug use.
We started interviewing and filming families who have lost loved ones to prescription opioids and heroin.”
YouTube link for short summary video of interviews:
https://www.youtube.com/watch?time_continue=131&v=HBkG0FxeMDU

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