America’s Love Affair with Opioids

Andrew Sullivan’s 2018 article for the NY Magazine entitled “The Poison We Pick”, wrote: “…For millennia, the Opium Poppy has salved pain, suspended grief, and seduced humans with its intimations of the divine. It was a medicine before there was such a thing as medicine. Every attempt to banish it, destroy it, or prohibit it has failed…This nation pioneered modern life. Now epic numbers of Americans are killing themselves with opioids to escape it…According to the best estimates, opioids will kill up to half a million Americans in the next decade.

“Most of the ways we come to terms with this wave of mass death…miss a deeper American story. It is a story of pain and the search for an end to it. It is a story of how the most ancient painkiller known to humanity has emerged to numb the agonies of the world’s most highly evolved liberal democracy. Continue reading “America’s Love Affair with Opioids”

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…”

KNOW YOUR ENEMY

“Know your enemy” is a phrase that repeatedly returns to my mind when I am looking back on the years of our children’s adolescence. Regrettably, what we have learned is too late for our son, but not for millions of other sons and daughters. I believe that we are at war with an enemy that, as it is taking the lives of our children, it is also taking the future of our nation and our world.

If you know the enemy and know yourself,

         you need not fear the result of a hundred battles.

If you know yourself but not the enemy,

         for every victory gained you will also suffer a defeat.

If you know neither the enemy nor yourself,

          you will succumb in every battle.

The Art of War by Sun Tzu (Chinese military strategist, 5th century BC) Continue reading “KNOW YOUR ENEMY”

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.

Triggers

A young friend visited our blog this week and had a very disturbing experience. She is a recovering IV drug user and someone I rely upon for  honest input and opinions on drug addiction and recovery. She is one of the few opioid addicts we know who has survived to have a second chance at life.

When she saw the image of a needle in a spoon she said: “I absolutely can’t handle that kind of trigger. For the families of users and people in recovery, that image is especially traumatic. It would make my parents panic, and it made me panic also.”

I felt so unwise – and sorry. I thought back to why I had used that photo. It was one we found on our son’s phone months after he died – I was stunned when I saw it and found that he had taken it two weeks before he died. The fact that he took that photo, documenting his using, was so distressing to us – I felt he did it to urge himself to get help but just couldn’t. 

I wanted the photo to convey the reality of what we, as families of addicts, face in our daily lives. But, as another young recovering addict friend said: “It’s like having a graphic image of someone on their death bed being injected with chemo – and trying to use that for an article about cancer. It adds shock value, but not too much else.”

So what are triggers? Are they the same for everyone? Our son said it was not hard for him to be around us when we were drinking alcohol – it was his decision to drink or not. But that was not what actually happened when he was around friends and alcohol – he ended up drinking – and then relapsed on drugs. We don’t know what the other triggers were for him with opioids, but when an addict sees things that they associate with drugs and their own using, it causes intense cravings, memory flashbacks, PTSD symptoms, racing heart, panic – and ultimately a step towards finding and using their drug of choice.

There are many good articles on internal and external triggers for addicts and alcoholics. I will summarize a few important points from this article, well worth reading: Understanding Triggers

by Sonia Tagliareni  https://www.drugrehab.com/recovery/triggers/

Long-term drug use creates an association in the brain between daily routines and drug experiences. Individuals may suffer from uncontrollable drug or alcohol cravings when exposed to certain cues. The cravings act as a reflex to external or internal triggers, and this response can even affect individuals who have abstained from drugs or alcohol for a long time.

External triggers: are people, places, activities and objects that elicit thoughts or cravings associated with substance use…A NIDA study maintains that exposure to drug-related objects may influence a former addict’s behavior. The brain registers these stimuli and processes them in the same areas involved in drug-seeking behavior.

Internal triggers: are more challenging to manage than external triggers. They involve feelings, thoughts or emotions formerly associated with substance abuse. 

Stress: stress rendered people in recovery more vulnerable to other relapse triggers.

Another good article:

https://www.thefix.com/content/triggers-addiction-dawn-roberts0318

I am grateful for the feedback from our young friends. Reviewing the role of triggers has been an important reminder that there are many friends and strangers who need me to be more thoughtful about what they are struggling with on a daily basis and to take the time to find out what I can do – or should not do – to support their recovery efforts.

The Hijacked Brain

I watched an interview on the PBS Newshour the other night with a physician whose young son recently died of a heroin overdose. He has started a foundation to help raise awareness and to bring an end to this deadly epidemic. My husband and I connected with him on so many levels: having a wonderful and brilliant son – who desperately wanted to be free of his addiction – die a needless death; the remorse over not knowing what we could have done differently to help our son; the desire to do something to help others before they are forced to share our pain and grief. In the interview he reiterated the truth that few people understand about opioid addiction: once a person is addicted to opioids, they are truly not normal or themselves any more. The drug has hijacked their brain and they are not capable of thinking normally. They must have the drug at any cost.

This is the reason that there are so few opioid addicts who live long enough to enjoy recovery, as opposed to addicts who use uppers like cocaine or meth. As Tracey Helton Mitchell said in her memoir, The Big Fix: “Heroin kept me chasing my tail, but crack (cocaine) finally sent me into recovery.” Our son’s addiction doctor put it this way: “Most people will build up tolerance to opioids and that tolerance is what leads to addiction. Once addicted, it is only over a long period of time with medication and group therapy (like the 12-Steps) that a person has hope of being free. This is why I call it the cancer of brain diseases’.”

In her article in The Washington Post, December 1st, Dr. Sandra Block (a neurologist) gives further evidence as seen on EEG’s on the changes to the brain that opioids cause:

“Neurologically speaking, opioids are crafty. They turn the brain’s own electricity against it, rewiring connections in an endless feedback loop for more drugs. They trick the brain into a death trap, as users chase the chemical bliss from the drugs with more drugs. Acute opioid usage (that is, the high itself) translates into slowing on the EEG. Usually, such an effect is transient, carefully monitored by an anesthesiologist during surgery, for instance. But when the patient becomes the anesthesiologist, the cycle can become lethal…the opioids overwhelm the brain’s respiratory center, causing cardiac arrest… I’m seeing brain death in people who haven’t lived their lives yet, whose brains haven’t even fully developed, brains that are literally killing themselves for drugs.”

My goal in sharing this information is that it will bring awareness to families and friends – and addicts – about why opioids are so pernicious and that we will begin to see those trapped in the addictive spell as individuals who really do want help. Learning what actual help is, as opposed to enabling the addiction, is a topic for another time.