fatal drug overdose – Opiate Nation

Yesterday, my husband John, and I, along with family and friends, celebrated my father’s life of 92 years with a beautiful memorial service. He was buried with military honors for his service during WWII. In the week since his death, friends have asked me how I was feeling about his death – knowing that this death is the now the fifth death in my immediate family since 2001. First my younger brother at 40 from AIDS, then my sister at 56 from breast/brain cancer, then my son at 25 from a heroin overdose, then my other brother at 51 by suicide – and now my father.

This death, of a great-grandfather, is different than the previous four in so many ways. Not only do we expect grand-parents to pass away before their children, grandchildren, great-grandchildren, but we know by the 10th decade of life, the day to meet our maker is fast approaching. For my father, he was doing quite well mentally, but his health was declining rapidly this year. By August, we knew his days were numbered – and so did he. The dying know they are dying, and for my father, it made him sad. He loved life and he loved his family. And even though he had a strong Christian faith and confidence in waking up in a new and unimaginable existence with his loved ones who went before him, he still had a very natural trepidation of the process of dying.

His last two weeks were marked by no appetite and finally no ability to even drink – his body was done with this life. With John holding his hand, he took his last breath and his spirit left the room – and left this earth. How did I feel? Sad because we will no longer enjoy his presence, and his death marks the end of an era of the large Italian family dinners and parties. But I was also relieved that he was no longer suffering in a body that was giving out.

The unexpected death of our son from a heroin overdose was different in every way imaginable. I look back now and wonder how John and I made it – how we didn’t end up institutionalized under heavy medication. I remember in the first few months feeling that my mind was on the verge of splitting in two – my heart was already broken – but it is our minds that hold us together. The love and support from our close friends and family surely were part of that glue. But the real potion that caused us to not tip over the edge was the mercy and grace of God. Without Him, we wouldn’t have had the courage to go on or the strength to look ahead with hope of an eternity with our son and with our other family members.

For those of you with friends who have lost a child to a drug overdose, please remember that a sudden, unexpected, preventable death is different from all other losses. These deaths are not natural, the lives were not completed, the parents and family can not just move on. They need your love and support – and prayers.

Mac Miller – 26 year old rapper – died of an apparent overdose last week. One more beautiful young person lost in the prime of life. Friends and fans have unanimously said he was one of the sweetest guys they’d ever known with a great sense of humor. Miller spoke openly about his struggles with addiction over the years: “It just eats at your mind, doing drugs every single day, every second. It’s rough on your body.”

August 31st is International Overdose Awareness Day. I think we are all very aware of the enormous and continuing-to-rise number of drug––mostly opioid––overdose deaths. It is clear from conversations with many of the famous and not-famous users, like our son, that they have every intention of controlling their addiction and no intention of overdosing. But something goes wrong…

Dr. Jana Burson, an addiction treatment physician in North Carolina, has a great blog (https://janaburson.wordpress.com/) with insights gathered from her patients, many of whom are long-term opiate abusers. “I’m not gonna overdose. I know my limits.” Dr. Burson writes in August 2017: “I really hate hearing these words. Usually patients say this in response to my concerns about their pattern of drug use while I’m prescribing methadone or buprenorphine. But many patients feel they are the experts. They can’t imagine making a deadly mistake with their drug use. But I’ve heard this phrase from people who are now dead from overdoses.”

She recently cited a study in Australia 2013, where overdose deaths have risen steadily since 2007. In that country, unlike the U.S., heroin use is declining while prescription opioid misuse is rising. This study looked at non-fatal overdoses in very experienced people who inject drugs––an average of 21 years of IV drug use––half of whom were in a MAT (Medication Assisted Treatment) drug program.

Most of these overdoses happened in private homes––many the subjects said they were impaired by alcohol or benzodiazepines. Over a third of the subjects had used fentanyl, a very powerful illicit opioid, leading up to the overdose. The authors of the study concluded that these experienced drug users were aware of common risks for overdose, yet drug intoxication from sedatives such as alcohol or benzodiazepines may have clouded the user’s thinking when injecting opioids. They also found that unexpected availability of drugs contributed to overdoses.

This was our son’s story: It was his first night after 6 months in sober living––but it was not his first night using again. He had been on Percocet for oral surgery (a huge mistake) a month before he overdosed and then had returned to IV heroin use the week before his overdose. He had been drinking with friends the first night in his new apartment––his decision making abilities were impaired. We are not sure exactly how much heroin he injected, and since it was Black Tar heroin from Mexico, the strength is absolutely unpredictable. What we do know from the autopsy is that he had many times more heroin in his body than a fatal dose. His was an overdose that he would not survive. Was this his last conscious thought: “I’m not gonna overdose. I know my limits.”?