What We Wish We Had Known…

August 2nd was the 5th anniversary of our son, John Leif’s, death by overdose from heroin. As we look back over the years, there is so much information available now than there was for the families of young people addicted to opioids in the early years of this century. So much we wish we had done differently with this son of our hearts – if we had only known.

In the early years of his addiction and recovery programs, we learned how co-dependency and enabling went part and parcel with alcoholism and addiction in family systems. We read all we could about it and worked hard to change from enabling and need-based love to detaching and loving with “tough love.” Sadly, as we now understand, tough love does not work for opioid addiction, because as Dr. Nora Volkow, director of the National Institute on Drug Abuse, says: “The concept of letting children hit bottom with opioids is not the best strategy, because in hitting bottom they may die.” Continue reading “What We Wish We Had Known…”

ANXIETY, Part 1

In the summer of 2005, we discovered our 16 year old son was smoking “BT” ––Black Tar Heroin. A few weeks later, while we were in the midst of his withdrawal and simply putting one foot in front of the other as we searched everywhere trying to find the next step, I was rushed to the ER. After going to bed one night, my heart began racing and pounding out of my chest. After an hour, John called 911. At the hospital, I was given tests to see if I was having a heart attack. No. The diagnosis: extreme anxiety––deep, un-verbalized, foreboding. I was given IV morphine and as my heart rate slowed down, I slept. Who else but our children can affect our hearts at such a fundamental and unconscious level? Continue reading “ANXIETY, Part 1”

JUST SAY “NO” TO FAILED DRUG POLICIES

I recently returned from Australia and began to connect with the addiction community there via several agencies and their newsletters and articles. One very thoughtful article published by Family Drug Support Australia (FDS) is excerpted here. Written by an emergency room physician who is on the front line with overdose victims, he is also a parent who is concerned for his children’s future unless drug policies in Australia change sooner rather than later. There, as in the US, bureaucrats spend years discussing options for change while people die in the tens of thousands. However, from people I’ve spoken with there and from all I’ve read, they are ahead of us in some significant areas. May we all learn from each other. Continue reading “JUST SAY “NO” TO FAILED DRUG POLICIES”

WITH or WITHOUT HOPE?

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.

Woman of Substances

In 1979, the novel A Woman of Substance was published. It was the first in a series of seven portraying the substances and schemes, the means and maneuvers of three generations of a retail empire. Being “a woman of substance” is considered a great compliment for a woman who aspires to be influential, a woman of power, a positive influence. 

In a clever spin on this phrase, journalist and author Jenny Valentish has written Woman of Substances. I picked it up last year while in Melbourne, Australia and I couldn’t put it down. Her narrative flair for relaying her personal experiences while presenting scientific findings on addictions of all  sorts is extremely engaging for women – and men.

Jenny’s nutshell:

A girl falls down a rabbit hole. She obeys every ‘drink me’, ‘eat me’ prompt and meets all sorts of freaky characters. Chaos ensues. Then she wakes up and exploits her position as a journalist to ask experts what that was all about.

Although it is not a memoir per se, her blatant honesty and self-deprecation about her past and her choices is revealing, while not glamorizing the depths to which her addictions took her. She interviewed 35 clinicians, counsellors, doctors and academics about their fields of expertise and shares her personal experiences of her up and down road to recovery and sobriety.

The chapters cover: The roles of temperament and impulsivity in addiction. Hitching adolescent identity to substances. Internalized misogyny as a contributing factor. The relationship between substance use, eating disorders and self-harm. Sexual assault and spiking. The impact of childhood trauma on the brain and behavior. Related foibles, such as gambling, theft, compulsive buying and compulsive sexual behavior. Self-medicating mental illness and PTSD. AA and other forms of treatment. The ways in which research and treatment is geared towards the male experience.

My husband, daughter, and I had the privilege of meeting with Jenny for lunch in Melbourne last week. She is as real in person as she is in print. We discussed current trends of drug addiction in Australia along with recovery and family help groups she is connected with.

What reviewers are saying:

“Raw, revealing, at times heartbreaking, but searingly honest and aimed to support anyone who is wondering if they will ever recover from addiction.”

“This book taught me things I wasn’t expecting about the landscape of substance use. You don’t have to be a spectacular comet of crazy like the young Valentish to find something of yourself in these pages. I can’t imagine there isn’t a young person, friend or parent who won’t get something important from reading this book.”

“Like a tour guide in a foreign land, Valentish waves a flag and provides a path back from the abyss. This is an enormously compelling, confronting and informative piece on addiction and recovery from a female perspective.”

Ultimately, Jenny show us that being a Woman of Substances keeps you from being influential, powerful, and a positive influence. As we told her, we are proud of her determination to truthfully relay her failures and her persistence in walking the uphill road to wellness and freedom. They will assure her place as a powerful and positive influence on this generation.

www.womanofsubstances.com

You can purchase Woman of Substances on Amazon or at your local bookseller.

Change Our Way of Thinking

In the 1970’s, Bob Dylan sang: “We’ve got to change our way of thinking, make ourselves a different set of rules…”

I thought about this song recently as I remember how differently we, as parents of an opiate/heroin user, thought a decade ago. We thought, and were taught, that if our son just worked the 12-Steps hard enough he could gain lasting sobriety.

We had an abrupt and jolting wake up call on August 2nd, 2014. And what we have learned since our son’s death is that it’s just not that simple. Yes, there are opiate addicts – better, those with Substance Use Disorder – who have survived this deadly addiction without Medication Assisted Treatment (MAT), but they are few and far between. And they did not achieve sobriety with one attempt.

Last week,I heard an update on the current Ebola outbreak in the Congo. Two hundred people have died already and those fighting the battle are using every resource possible to contain it. It is terrible.

What if we treated the opioid epidemic with the same urgency and resources?

A sheriff in a county near Seattle had a similar epiphany last year after he was elected sheriff. He toured the jail and and saw it had become a de facto detox center full of very, very sick people. TY Trenary said: “Detoxing from heroin is like having the worst possible stomach virus you can have. People are proned out, just suffering.”

Last year, leaders declared the opioid epidemic a life-threatening emergency. The county is now responding to the drug crisis as if it were a natural disaster, the same way it would mobilize to respond to a landslide or flu pandemic.

The county’s program includes small steps, like making transportation easier for people in drug treatment. They train family members and others in the community on steps to reverse overdoses with medicine, and they send teams of police officers and social workers to help addicted homeless people.

The new approach is paying off. The teams have helped hundreds of people find housing and drug treatment.

I have changed my way of thinking – how about you?

https://www.npr.org/sections/health-shots/2018/10/28/658476111/a-rural-community-decided-to-treat-its-opioid-problem-like-a-natural-disaster%20?utm_source=npr_newsletter&utm_medium=email&utm_content=20181104&utm_campaign=&utm_term=

BLOG: MAT, Part 2

MAT––Medication Assisted Treatment. Dr. Hillary Kunins, a clinical addiction expert, dispels the notion that treating an addiction patient with medication is simply exchanging one drug with another. Here is a link for a 2 min video where Dr Kunins offers a simple explanation of why physical dependence is not the same as addiction.

Here are the drugs that are currently in use for opioid addiction. Methadone has historically been used for heroin addiction, since the early 1970’s, when it was authorized by the FDA but restricted to daily dispensing clinics. Because it is an opioid-like drug, it has tended to only keep addicts alive, but never really able to be drug-free.

Nearly a half-century ago, buprenorphine was developed in England, where chemists were competing to invent a less addictive painkiller than morphine––it turned out to be far more addictive. It is now sold as Subutex and is an opioid partial agonist. An agonist is a chemical that binds to a receptor and activates it, producing a biological response. Like heroin, buprenorphine attaches to the brain’s opioid receptors creating euphoria, but it does not plug in as completely, so its effects are reduced. It is slower acting and longer lasting, attenuating the rush of sensation and eliminating the plummets afterward. But there is still potential for abuse and it can produce side effects such as respiratory depression.

Naloxone (Narcan, Evzio, injectable or intranasal spray) was patented in 1961, and is an opioid antagonist—meaning that it binds to opioid receptors and can reverse and block the effects of other opioids by displacing them from the opioid receptor sites in the brain.Whereas an agonist causes an action, an antagonist blocks the action of the agonist. It has been used in hospital “code arrest” emergency situations for decades. It was used on me before a surgery when I had been given too much anesthesia and was beginning to go in to respiratory arrest. It is being carried by emergency personnel and families of addicts because it can very quickly restore normal respiration to a person whose breathing has slowed or stopped as a result of overdosing with heroin or prescription opioid pain medications.

Naltrexone (Vivitrol, monthly injection) is an opiate antagonist that is more slowly released than naloxone. It is primarily used to manage opioid dependence or alcohol dependence and abuse by blocking neural pathways to the brain for dopamine neurotransmitters. It requires going through complete withdrawals and detoxification first because it will not work until opioids are out of the system. People who try to take opioids after taking naltrexone are at risk for opioid overdose and death since it takes using large amount of opioids to overcome its effects.

Suboxone––four parts buprenorphine, one part naloxone––was approved by the FDA in late 2002. Generally, although not accurate, when the word “buprenorphine” is used, people are referring to Suboxone. In addition to side effects from the buprenorphine in Suboxone, if a person has been taking it for a long time and they no longer receive it, they will suffer withdrawal symptoms similar to those suffered when stopping other forms of opiates. And, suffering from these withdrawal symptoms can worsen underlying mental disorders like anxiety or depression. At times, withdrawal can become overwhelming, which happened to jL, which sends patients into buprenorphine abuse and dependency. This has created a debate over the use of Suboxone and Subutex for addiction treatment.

A new study in The Lancet (January 27, 2018), sponsored by the National Institute on Drug Abuse (NIDA), compared the effectiveness of extended-release naltrexone with buprenorphine-naloxone in the US. The results were both promising and disappointing. While naltrexone is as effective as buprenorphine-naloxone once treatment begins, it is also significantly more difficult to actually start naltrexone because of the prolonged detox period—which can span more than a week—that buprenorphine-naloxone does not.

The biggest regret we have had since our son’s death in 2014 is that we did not take his doctors advice and have John Leif on Suboxone. There were many reasons that went into this decision, but the main one was that our health insurance did not pay the costs for any “mental health” coverage. Since we had so many years of our son’s relapses and recovery expenses, we decided to let him just “try harder” with the 12-steps and a sober living house. Sadly, it was not enough for a young man who desperately wanted to be clean and free of his enslaving addiction––he need MAT and we believe he would be alive today if he had been given that option.