(Translation into most languages at tab to the right)
I wish everyone could read the penultimate chapter of The Least of Us by Sam Quinones. Its title is the same as that of the book. I have almost every line underlined and starred. In it, he describes the dire state we in Western society are in with addiction, the well-thought out reasons many of our public policies are still getting it wrong, and the slivers of hope that encourage us that the world could look differently for the next generation of young people. Some poignant quotes:
“Underground chemists seem to be searching the chemistry literature for drugs that might be molecularly modified to be more potent…The world Gary Henderson predicted when he coined the term ‘designer drugs’ in 1988 is now with us. Counterfeit pills laced with fentanyl (and new synthetics every day) and made in Mexico now dominate the market…There seems now no way to stop all the bizarre drugs devised by those whose own brain chemistry has been twisted by the profits of the underworld’s free market…recovering addicts face scary odds as long as the drugs that torment them are widely available, potent, and almost free. The now-cliché is ‘We can’t arrest our way out of this.’ We can’t treat our way out of it either, as long as supply is so potent and cheap.”
(Translation into most languages at tab to the right)
“We were trying, all of us, so hard, and he just wanted to live.” (1)
Ursula Rauh said this about her brother, Tommy, after his death from a fentanyl overdose and a dozen stints in rehab in ten years. He became addicted to Oxy’s at 23 after being prescribed an unlimited amount for tendinitis and a year later, another prescription for wisdom teeth extraction. Sam Quinones retells the family story in The Least of Us: True Tales of America and Hope in the Times of Fentanyl and Meth. “The tragedy wasn’t just the death of her brother; it was all the time, effort, love, and pain that the family traversed, the hoping and living for the smallest encouragement.” (1)
When my husband, John, and I returned from Australia in May, we decided that we needed to address the decades of files we had saved and ‘stuff’ we had accumulated and ‘stuffed’ away in closets. We have shredded and recycled dozens of boxes of documents, cleared out half the books in our library, and now I have moved on to scanning and sorting thousands of photos. While I was pulling bins of photos and albums out of closets, I came upon a few more file bins. I sighed out loud to John, “Oh boy…more of JL’s file’s I’d forgotten about.”
(Translation into most languages at tab to the right.)
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. John shared about our son’s addiction and death and how we hoped that by speaking openly about his life and writing our book and blog we could help in some small way. His response was something I did not expect and 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.”
An advocate is someone who works by speaking, acting, or writing truthfully on behalf of a person or group in order to promote, protect, and defend their welfare and to seek justice for their rights. To speak out for those who have no voice. But advocacy is not cheerleading. A cheerleader is someone who only supports their team or player – since they are in competition against another team. They are indiscriminate about what their team does or doesn’t do. They don’t necessarily look at the big picture or causes and effects. Their role is to simply cheer on their team or player and boost support from their fans with slogans that may or may not be true.
Serious problems that affect the wellbeing of individuals, communities, and entire societies, such as the Covid-19 pandemic, addictions, and racial prejudice and inequality, are not helped by cheerleading. People in danger and suffering need advocates who have compassion, who are truth-tellers, and who will vigorously and untiringly work for a solution.
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 – I long to be helpful in a meaningful way and become discouraged at my inability to do so. And if I feel discouraged, how must they feel? What will help bring real, substantive change and hope to these lives and in these circumstances?
As parents of a son with a deadly addiction, we were sometimes cheerleaders when we needed to be advocates. Cheering him on and telling him he could do it without any medical help was not being realistic or being the advocates he needed. I think it is difficult to be an effective advocate for those we love because we are too close to have a clear perspective. Which is why a supportive recovery community – for both the family and the one struggling – is vital. We must try and use whatever resources we have: our voice for those who are not being heard, our writing to bring clarity to public thinking, our physical presence to stand or march with others, and our time, energy, and finances to step in where we can or offer help to find those resources.
There are as many ways to be an advocate as there are needs in this world. I have friends involved in racial justice, in refugee struggles, in stopping sexual exploitation and abuse, homelessness and poverty – the list is endless. The question is: How can each one of us be an advocate for the people and needs we are aware of and that we have a passion for?
Translation into most languages at tab to the right.
A few weeks ago, John and I were interviewed by Jeff Simone for his Surviving the OpioidEpidemic podcast (see YouTube link). We had a really great conversation about our family living with a teenage son with opioid addiction and how his death from overdose affected us and changed our lives. Jeff serves the addiction community with a coaching service called Reaction Recovery.
Here are some insights into his recovery approach.
Reaction Recovery is a private coaching service designed to help individuals thrive in their life of recovery from substance use disorders. It is a one to one, intensive behavioral approach to help individuals identify areas to make focused and intentional lifestyle modifications. Dr. Simone has been formally trained in clinical pharmaceutical and dietary supplementation advisory and management. He has earned degrees in nutrition, physiology, is a certified life coach, and has personally worked with over 200 people recovering from substance addictions.
Why ‘Reaction’ Recovery? Who is reacting and to what?
Reaction Recovery was started as a “reaction” to the current treatment approach to addiction. The medical community is doing a good job offering short-term acute care crisis management for addictive disorders, but are doing poorly offering long-term treatment for those who have become abstinent but not yet stabilized. This describes our son’s – and most others we know – situation perfectly. Addiction needs long-term care and support.
The basic coaching approach addresses the physiology of the addiction, post-acute withdrawal syndromes, nutritional interventions, dietary supplementation, and how this all can safely integrate with other pharmaceutical treatment strategies that might already be on board.
Based on what Dr. Simone has called the ’12 Daily Rules for Recovery,’ their coaching techniques will systematically and methodically help the individual identify specific areas to be adjusted and then develop individually tailored strategies to affect real change.
The 12 Rules focus on building up a support community – first and foremost – then developing a healthy and consistent morning routine, understanding the importance of full-day nutrition, ensuring the body is receiving all nutrients necessary to support a strong and optimal brain and body, establishing a safe and appropriate dietary supplement regimen, expanding the mind with helpful books and information, developing a realistic exercise routine, carefully auditing the external distractions in our lives, constructing a regular nighttime routine, and more.
When these considerations get repeated across thousands of iterations, and with a little guidance and accountability, they become a foundation upon which the rest of the individual’s recovery will be built. Eventually – through ruthless repetition – new neural pathways begin to form until eventually this life of abstinence doesn’t feel so difficult and a sustainable, meaningful recovery is able to take shape.
Jeff’s approach of community as essential and creating new, healthy habits to replace old, destructive ones has been the topic of several of my blogs (see below). Whatever habits we create will become automatic and will serve us and our life-goals well as we go through each day.
(Translation into most languages is available to the right.)
When I am doing research for an upcoming blog post, I can get lost. There is so much information now on drug addiction and the opioid epidemic that I suddenly look at the clock and realize I’ve been wandering virtually around the world and becoming more discouraged with each new article or report: Scotland has more drug overdose deaths per capita than any European country (1); Fentanyl is flooding California with overdose deaths skyrocketing (2); the use of over-the-counter codeine (an opiate) cough medicine among eighth graders in the US has increased (3); and, Australia now has the eighth-highest per-capita opioid consumption in the world (4).
(Short topical blog based on Opiate Nation – translation into most languages in tab on right.)
August 2nd is the seventh anniversary of our son’s death. JL died of a heroin overdose in the early morning hours of that Saturday in 2014. He was 25 years old.
In 2020 alone, 93,000 people died of drug overdoses in the USA – hundreds of thousands more worldwide. Millions in the past few decades. These were beloved daughters, sons, partners, parents, friends, relatives. I think I can confidently say they did not want to be addicted and if they could have turned back the clock to the time before they began using drugs, they would have.
(Short topical blogs based on Opiate Nation – translation into most languages in tab on right.)
When we hear the phrase “ghost stories” most of us think of scary and spooky stories shared around a campfire with the intended, and predicable, consequence of keeping us awake at night.
But when H Lee (aka Harris Insler) decided to call his new podcast series “These Ghosts Must Be Heard”, it wasn’t because he would be interviewing people with paranormal experiences. And although the stories his guests share aren’t scary in the ghoulish sense, they have kept their narrators awake at night for days, weeks, and months on end. John and I included. (To hear our interview with Harris, see links below for Podbean, Amazon, Spotify.)
These are real-life experiences and these “ghosts” are the spirits of our deceased loved ones: children, friends, partners who have succumbed to premature and preventable deaths from opioid overdoses.
(Twenty-eighth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
Memories are strange things. How much control do we have over them? What triggers bring up which memories? How do triggers differ with each individual personality? Does grief affect memory? I know it does mine because I continue to experience new associations and memories being formed from what were once familiar items with no particular memory attached before—which now, after my son’s battle with addiction and death, have a specific memory related to him.
(Twenty-sixth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)
Nine months after our son, JL’s, sudden death, we were gradually unearthing our grief, as we gradually unearthed pieces of his life. We were miners searching for something precious, digging through the layers of years as if through layers of rock. Or perhaps we were more like survivors of an earthquake. Our entire earth, with everything we had built on it, was suddenly shaken to the point of collapse, and we were sifting through the remaining buildings and rubble to see what was left. Deciding what to keep and what to dispose of. “Dispose of” has new and unwelcome meanings now. Clothing, personal belongings, furniture, files, photos, childhood toys, keys, memorabilia.
John’s journal entry on May 12, 2015 expresses some of our feelings:
Dear JL,
It’s dad again. We are going through more of your things and I spent a half-day shredding your old papers and notes. It is so odd that much of our lives comes down to boxes of paper to shred. This is very, very hard for me. Shredding your life.
I love you – Dad
Grief is about what is going on inside us after a loss—how we feel. We have no more control over it than we have control over other feelings. Our choice involves how we deal with it.
Mourning is the action of dealing with our loss—what we do, the common rituals, the external part of the tragedy. Again, we choose how we mourn.
Some people put acts of mourning off indefinitely – leaving a deceased loved one’s belongings just as they were when they died until they die themselves. Others, urged on by society or their own distraught emotions, will almost immediately begin sorting and throwing. For us, there were some natural milestones when deep inside we seemed to know it was time to face the loss of another part of our son’s life. The grief-work we were engaged in – being aware of the various stages of grief and facing them as they surfaced – was our internal guide. We never let societal custom or any external pressure guide us, while we did read and listen to other’s experiences.
One thing became clear: this loss of our child was very, very different than the loss of our parents or siblings. Although each of those were difficult in their own distinct ways, the level of personal pain with our son’s death was unique. He was an intimate part of who we are – of course – he came from us. As he grew and became his own person, he yet remained a part of our life and more significantly, our future. All is engulfed in a thick fog. Which is why the quote in the photo is so poignant:
When you lose a parent, you lose the past. When you lose a child, you lose the future.
(I am taking a break from the chapter by chapter topics from Opiate Nation to focus on the significance of this holy week. Translations into most languages available at tab to the right.)
Spring is the season of regeneration, freedom, new life. The time of year when the whole earth seems excited to be alive after being dormant all winter. For the northern hemisphere, March and April are Spring – for our friends and family in Australia, right now it is Autumn. Regardless of what season it is where you live on this planet, it is Easter Sunday and the end of Passover week. Both the Christian and Jewish traditions celebrate the freedom from bondage and the beginning of a new life, although from differing perspectives and beliefs. Both begin the time with reflection and prayer. (I don’t understand Islamic tradition well enough to comment on it except to say that Ramadan is observed around this same time of year with introspection and fasting in remembrance of Muhammad receiving the Quran.)
For Christians, the freedom is from the bondage to sin in one’s life; for Jews, it is the freedom from bondage that the Israelites suffered under in Egypt. Both faiths look to an historical event in the past. They also remind us that while bondage was dealt with symbolically once – whether personally or communally – it is an ongoing problem in this imperfect world.
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.
Opiate Nation 