A front-page Washington Post article about a 16-year old’s heroin overdose caught my attention recently as I read through papers I had missed. The story is becoming all-too common throughout the Washington, D.C.-Baltimore, MD-Annapolis, MD triangle, where I live.
Who can say what tempted a young woman—a girl, really– to allow another young adult to inject her with heroin? By all accounts, the girl had not tried drugs before. When she lost consciousness, her “friends” did not respond as if it were an emergency; instead, afraid of the consequences they might face, they ditched her in shrubs and covered her with window screens. Police found her body a few days later.
As I read the article, I felt for a moment that I was back in the D.C. of the early 1980s, when crack was killing young adults everywhere, and the motto of the day was simply “Say no.” The Post article quotes an unnamed official as trying to “temper” the “disturbing trend” of heroin overdoses by “by explaining how potent and unpredictable the drug is.”
Indeed, the unpredictable drug—on the East Coast, lately, laced with an opioid called fentanyl—is Suspect No. 1 in the recent death of Philip Seymour Hoffman, dead at 46, a syringe in his arm, and 50 glassine packets of a heroin-like substance in his New York apartment. Since September, at least 37 Marylanders have died, too.
“Do officials honestly think explaining the dangers of drugs and alcohol will prevent the usual teen or young adult from experimenting with them? Young people thrive on risk, or are happily unaware of it.”
Do officials honestly think explaining the dangers of drugs and alcohol will prevent the usual teen or young adult from experimenting with them? Young people thrive on risk, or are happily unaware of it.
As the mother of five young adults and a middle schooler, I can testify to having observed this behavior time and again. My advice, fears, and information generally went disregarded, by-products of my worrying, my kids thought, or fear mongering.
Indeed, two of the six eventually found themselves in rehab facilities. One, now 21, has been clean for almost five years, a journey that challenged and sometimes overwhelmed both of us.
Recognizing that one’s child is addicted to drugs and alcohol is terrifying—and getting effective, affordable, and appropriate treatment can become a full-time occupation, even for parents who are themselves well-educated, well-connected, and well-insured. For years now, a family member has waged a near constant battle in seeking help for an adult child addicted to heroin; fine print on a gold-plated health insurance plan can, in fact, kill people.
What we know about effective prevention and treatment is an odd mix of snake oil and evidence-based medicine. Even as science and medicine point more and more to biological factors that can predispose some to addiction (never mind, also, the risk factors of untreated mental illnesses, such as depression, or the abuse rabbit hole that prescription opioids have created for many), many treatments today simply promote the AA 12-step model of the 1930s.
A 2012 study from Columbia University, Addiction Medicine: Closing the Gap Between Science and Practice, describes the many shortcomings in current practice, including the problem of identifying people and referring them to treatment. Last year, Jane Brody of The New York Times wrote an insightful two-part article on the challenges of treatment, pointing to Anne M. Fletcher’s book, Inside Rehab.
The sad reality is that addiction is a chronic, relapsing disease (or disorder—call it what you will, it kills people, it robs them of meaningful lives and relationships, and more), and those who live with it often need much more than group therapy, or turning it over to a Higher Power, or (as Seymour Hoffman had) 10 days inpatient treamtment.
In fact, by the time many people find that they need or want treatment, they need help in other aspects of their lives: employment, housing, and medical care. To that end, federal and state programs that focus on recovery-oriented systems of care, try to build a community-wide response into the safety net.
Life sometimes seems to delight in throwing irony our way. In my case, I wrote for years about mental health, as well as substance abuse. My former husband was an alcoholic, as were various family members. It was a life I knew too well.
Recognizing One’s Own Dependence
But in the course of writing about it, and in living it with my own children, I did not see my own problematic relationship with alcohol. It was an issue, but I kept putting off dealing with it. I played games with myself, and with drinking. Denial was my helpmate.
Then last Feb. 2, after dropping my daughter off at college, I found myself anxious to get home to have a glass of wine. I knew, of course, that there was no such thing as “a” glass of wine for me. And a four-ounce glass? Please.
“Then last Feb. 2, after dropping my daughter off at college, I found myself anxious to get home to have a glass of wine. I knew, of course, that there was no such thing as “a” glass of wine for me. And a four-ounce glass? Please.”
But the fretting over it as I drove home troubled me—and so I got home, poured out all the wine in the house, and searched online for a group I had heard of called Women for Sobriety. At this very minute, 38 sisters are on the discussion board. More than 9,000 women around the world belong to the group. Members adhere to a series of statements that focus on their own strengths and abilities, the “4Cs”” capable, competent, caring and compassionate.
I have shared much over the last year with other women on the board, seeking their support, and offering my own. The group hosts an annual conference, publishes a regular newsletter, and provides a wealth of resources to women who ask.
Again and again, when someone posts about how hard her life is, or how impossible it has become, dozens of other women respond almost immediately with concern, and with a reminder that there is nothing in the world that can be made better by alcohol.
But until now, I have kept this aspect of my own life very private and quite hidden. Acknowledging that alcohol had become a problem meant, in my mind, acknowledging that I was a failure at best, and a hypocrite at worst. I felt shame. I feared the stigma. I hid.
Then Seymour Hoffman died, and I decided to speak out. So many years ago, at the start of the AIDS epidemic, its activists and sufferers would come to FDA meetings and wear shirts that said, “Silence=Death.”
It does, truly. When it comes to addiction, silence does even more than kill: It shames and isolates people, it stigmatizes them, and a guarantees that nothing ever changes. It all but ensures that hundreds of more people will die, sitting in their bathrooms or in their bedrooms, needles in their arms.
Avoiding addiction demands that we do a lot more for ourselves and the people we love than exhort them to “say no”. We need to acknowledge what is happening. We need to continue to search for evidence-based treatments that offer hope and recovery.
We need funding for individuals who cannot possibly afford the out-of-pocket expenses of treatment. We need to know that our stories can aid one another, and that they will not be a factor that drags us under. And surely, we need to learn.
By all accounts, Philip Seymour Hoffman was a gifted man—and he could certainly afford treatments that might have helped. But addiction does not discriminate: All ages, races, communities, income brackets, sexes endure it. There is no 1%, or even a 47%.
But surely all of our voices, raised on behalf of all whom we love, can push us to 100% better treatment and care and compassion.
This essay originally ran on Disruptive Women in Healthcare.
- No Children, No Regrets
- Brené Brown Talks to The Shriver Report: The Power of Shame on Women Living on the Brink
- Elizabeth Gilbert’s Advice to Women: Get Out of Your Own Way
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