(Ninth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
Shells are beautiful and fascinating to me. Each and every one is unique, differing from others just like our fingerprints. John and I just spent time at the central eastern coast of Australia and on our daily walks on the beach I just couldn’t stop picking up shells – especially the Nautilus shells with their logarithmic spirals of every size, shape, and color. These are empty shells that were once the home of a sea creature.
The exoskeleton of mollusks is the hard, outer layer that protects the tender creature inside. As the creature grows, layers are added to accommodate it. One day, as I was picking up shells in the surf, the inhabitant was still inside. It immediately retreated as far back into its shell as possible.
(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.)
After many years of not having a dog, we decided to adopt one from our local shelter. We found a beautiful German-shepherd/wolf mix who was 18 months old. Bella was docile, sweet and quiet. The next day, as I headed out to the grocery store, I gave her a hug and saw her watch me through the window as I got into the car.
When I returned an hour later, I was met with a shock. I found her, panting rapidly and pacing nervously in our bedroom where our wooden shutters were open and had bite marks. She had tried to escape while I was gone. I had no idea why. I immediately called the shelter. “She is having separation anxiety: she needed to escape being left alone.” We found out that she had been with two families previously when she was dumped at the shelter because she continued to try to escape when she was left alone for hours on end. They gave us the name of a dog behaviorist and we started down the long road of helping Bella manage her fear when we had to leave her at home.
Children and adults can experience separation anxiety when someone they are attached to leaves them. They can have recurrent and excessive distress just anticipating being separated from loved ones and the anxiety can be so intense that it is hard to function in everyday life. Panic attacks and physical symptoms such as nausea and headaches can occur. For me and my husband, on the morning of our son’s death from overdose, standing over our son in that body bag we experienced the ultimate separation anxiety. The overriding emotion we felt was fear: fear of the unknown future we were facing. We couldn’t visualize how we would survive without our son as part of our lives and the future we thought we all had together. He had not only been an integral part of our lives for 25 years but he was literally a part of us–the combination of our DNA that formed him as a particular and unique human being. To say that it was like having part of you taken away doesn’t describe it. This was having our hearts torn out.
We would never embrace or kiss or stroke the cheek of our son again. We were facing an existential crisis, shaken to the core, questioning our reason for living. Regardless of our strong faith that had seen us through many other deaths in our families, this separation seemed incomprehensible and cruel. It was only by falling down on our faces and waiting for Mercy to gradually pick us up that we were able to survive this traumatic separation from our son and move forward again in life.
(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.)
Chapter 1: The Letter
Most of us have felt like we were “in over our head” at some point in our lives. Maybe it was in a job, or a class, or a relationship. Perhaps in the ocean, or on a steep mountain trail or having made a commitment to an event or project that turns out to be more involved and time consuming than we thought. When we finally realize there are more problems than we can handle or a difficulty that we just can’t surmount, what do we do?
I remember one time when John and I were in Morocco and the friends we were traveling with were gone for the day. We decided to explore a lighthouse we saw ahead. As we walked through an opening in a wall that surrounded it, we started to feel we might not be in a safe place. We felt fearful as we saw trashed looking apartments and expensive cars with black tinted windows. What made us turn and literally run was the sound of mean dogs barking. As we ran back through the opening, several came in view with their spiked collars and bared teeth. Thankfully, as we hit the main street, their owners called them off.
We are a global community – like it or not. We are connected down to the minutia of life, from what we breathe, to what we eat, to what we think, to what infects us. And right now, the world, our world is in a life-or-death struggle with a microscopic enemy that seems to keep gaining the upper hand. The result in just one area is massive unemployment and the subsequent loss of access and funding for public and private support services.
I don’t want to get in to the politics of whether economies should be opened up regardless of Covid-19 and suffer the consequences in lives lost, verses lives ruined by no work and massive personal and societal debt. What I am concerned about are the consequences of what so many millions of people are facing from having lost their means of livelihood, and in particular, those whose lives were already balanced on a knife edge on a daily basis.
It has been said that the 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…and 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.
With so much distress in the world with the Covid-19 Pandemic, especially the effects it is having on the weakest and vulnerable members of our societies, I have hesitated to announce a personal accomplishment. Yet, my hope is that as Opiate Nation gains more visibility, it will get into the hands of people who could be most encouraged and benefit from our story.
I am a member of a group of 35,000 women called “The Addict’s Mom” on Facebook. I confess, I rarely read the posts because it is so depressing: Story after story of mom’s who have been holding out for years to see their daughter or son released from the hell-hold of addiction to drugs, only to then post that “…today I lost my daughter/son…can someone tell me how I will survive this?” It is for these mom’s and dad’s and siblings and friends that we wrote Opiate Nation, but one of the stipulations of being a member of the group is no self-promotion. So I hope that, with more visibility and more reviews and re-posts on social media, our book will get to these most desperate of people.
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. At the end of the call, as I walked into the room, John told him about our son’s addiction and death and how we hoped that by speaking openly about him and through our book and blog we could help in some small way. His response was something I 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.”
His comment came to mind in the recent weeks as I watched millions of people around the world protesting against racial prejudice that lay at the heart of police brutality to People of Color (POC). They are advocates of racial equality as a basic human right. I thought: how I wish I could be helpful in a practical way to a problem I have watched change very little over the decades of my life. I felt anger and also frustration, wondering if all the sacrifice and effort would actually bring about real, lasting change.
It is the same feeling I have 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. And if I feel discouraged and hopeless, how must they feel? What will help bring real, substantive change and hope in all these circumstances?
In these weeks of living life in a new way with the Coronavirus pandemic, I have found myself doing something I am not normally inclined to do: choosing to look away from the ongoing Opioid Epidemic. Sadly, it has been easy to do. John and I arrived in Melbourne in March on the last flight from LAX allowing non-residents into Australia. When we planned our trip in January to be here for the completion and delivery of our new Tiny Home, Covid-19 was barely in the news.
After our 14-day quarantine, and during our first few weeks here, we were supposed to speak at two events which were cancelled. When the meetings switched over to Zoom, we were then able to share the story of Opiate Nation. It was well received and appreciated, as it brought to light pitfalls and vulnerabilities that parents and their children face in the 21st century. Since then, we have been busy setting up our new home, arranging installations, and finding furniture and appliances. We are thankful and feel blessed to be able to be here with our daughter and family – and to be in a country where the leaders have been honest and proactive, where the government has a wide social safety net and comprehensive health care for everyone, and where the public is almost uniformly willing to trust and follow their stipulations.
Meanwhile, in the back of my mind, I have continued to think about people struggling with addiction and wondering what their lives are like during these times that are challenging – even for the rest of us. With the restrictions to help slow the spread of the virus, many rehab and recovery programs are now not an option. For those who have had jobs, many of which are hourly-wage or temporary positions, they may now be unemployed. If they are taking medication as part of their harm reduction/medication assisted treatment, how will they pay for it?
When life on this earth results in tragedy and loss – personal, communal, international – we are immediately faced with choices we did not anticipate nor plan for. An untimely death, an assault or abuse, financial ruin, a health crisis, relational trauma, anxiety: the list is endless. What do we do? Most of us want to just turn and run while we also know there is no place to run to or to hide from the turmoil within. So how do we take the next step forward when everything in us doesn’t want to and we are facing a challenge we have never faced before?
We remember that we all have choices even when it seems there are none. It is what makes humans unique. Referring back to my blog “Darkness & Light” and the thoughts from Jerry Sittser in his book A Grace Disguised, when we choose to move towards the darkness knowing we will eventually see the sun rise, we find gifts along the way that we could have never imagined. But we also find more choices. Sittser cites Viktor Frankl’s Man’s Search for Meaning, reflecting on his time in a Nazi death camp and how “the prisoners who exercised the power to choose how they would respond to the terrible loss and darkness of their circumstances displayed dignity, courage and inner vitality. They found a way to transcend their suffering…and so grew spiritually beyond themselves…they learned that tragedy can increase the soul’s capacity for darkness and light, for pleasure as well as for pain.”
The other day I was thinking about our son and his struggles with drugs and alcohol and all that we know and understand now compared to what we knew and understood in the early 2000’s right up until his death in 2014. I saw myself, as if I were standing out in an open field, turning, looking back over my shoulder. That’s what I do when something unexpected or disturbing happens. I look back and try to figure out what I missed, what I could have done differently.
My next thought was: Why couldn’t my husband and I see the handwriting on the wall? Why didn’t we realize how dire the situation was at every new juncture with our son as the years went by? But, I realized that it wasn’t that we couldn’t see the handwriting on the wall. It was that we didn’t understand what it meant.
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.