Stats… STAT!

Our children relapse. We are warned “relapse is part of recovery.” But I don’t think most of us believe it. By the time your child has a few years under their belt you get comfortable. You see a person emerge that you haven’t seen in years. Someone who is genuinely happy. Focused. Funny. Confident. Surely this person is here to stay.

But the fact remains. A mom I know confessed to returning to the days of sending canteen money to her son after his recent relapse landed him back in jail. She ended her dark missive with “why, why, why?”

It’s a rhetorical question I suppose. We know why. Giving up anything for a lifetime is a pretty monumental task. Giving up something you once loved more than life itself must be harder. Then throw in the added bonus of having an addictive personality or a mood disorder. Those are some pretty good whys. Sometimes I am amazed at the fortitude required to obtain 2-3-4 years of complete sobriety. It feels like a miracle. But I don’t want to think this way. I don’t want my daughter’s future to be dependent on a miracle.

Last week my daughter called me from detox. It was her third attempt in ten days. Her voice was hopeless as she numbly reported “only 1% of addicts ever make it mom.” I also have heard this number quoted. And I don’t like it.

We know statistics are manipulated to present a particular point of view. Is this one in existence because historically we haven’t cared enough to get the math right? Or has it been cultivated to justify poor spending on treatment?

This number was ringing in my head when I sat on an opioid forum last week. Beside me sat the head of a Massachusetts hospital emergency room department. He confidently stated that “involuntarily committing addicts to treatment is not recommended because we are setting them up for a higher rate of overdose death.” I am presuming his reasoning was based on the premise that this population is not interested in quitting drugs and therefore would return to using. I don’t question that deaths are higher among the involuntarily incarcerated vs. the voluntarily committed when treatment ends. It makes logical sense. But the data is flawed. The data is flawed because of “patient selection bias.” The doctor failed to include those who were NOT included in the data: those not forcibly committed to treatment. I venture to say that most of them are dead – or will be dead. Look at it this way: it’s like playing Russian Roulette with people who don’t want to quit the game. If you take away the gun some may eventually go back to playing with the gun. But if you DON’T take away the gun… well everyone is going to die. It’s that simple.

Are there better stats regarding relapse? Unfortunately there is a dearth of long term data. One of the few long term NIH funded studies followed 1,162 addicts for eight straight years. Published in the Journal of Alcohol and Drug Abuse it revealed that as the length of time in sobriety increases, so do the odds of continued sobriety. Those with less than a year have a 33% success rate. Those with over a year increase their odds to 50%. And those who achieve five years can expect an 85% future sobriety success rate. Data just doesn’t exist for those with 20 or 30 years of recovery time; but those who work in residential centers find their reappearance rare.

So we know clean time breeds more clean time. I remember joking a few years back with a local officer.  I asked him to handcuff my daughter to her bedroom radiator to prevent her from scoring. He smiled, but then seriously replied “yeah, I can’t do that…and neither can you.”

Since that day I have been searching for a legal means to success.  That searching even led to attendance at a spiritually based reading group (disclaimer: it is an act of desperation for me to turn toward faith for any sort of answer.)  What I found was that many of those in attendance were living a life of successful sobriety.  History, science, and society have not been kind to those suffering from the disease of addiction so we can not blame them for remaining in the shadows.  AA and NA use “anonymous” for a reason.  But by sharing their status this group become a living example of hope and, even better, a room full of positive odds!

It is still going to take a lot of unbiased research to get us solid numbers to stand upon.  Faulty statistical analysis, unfunded federal research, a lack of evidence-based treatment, and social stigma have led us to this unsettling place. To live within the world of addiction is to stand on shaky ground.

For now I will tell you what I can do. I can share a whole new set of facts with my daughter when I visit her at the hospital. I can tell her with confidence that the 1% success rate is inaccurate. And I will tell her with even more confidence that she matters 100% to me.

These are the only true numbers at my disposal and, for today, we are relying upon them.

I Am Never Tired.

I am never tired.
I am consumed by the what-ifs.
A 100 pound mother in boxing gloves with starry eyeteeth.

You can not tell me to let it die.
I will not let it die.

My furnace is stoked with yesterdays newsprint
dirty fingers licked by white sleeves,
silver smoke smothering all rational thought.

But rational thought is a white flag,
and I am a-boil in shaky embers and the bluest of ash.
I am aware that we are both a-simmer
vein deep in illogical warfare.

But I will not accept the prophetic precision
with which you stick your self made kewpie doll.
Make no mistake this is a race
Desperately filled with
red poppies, red poppies
ground into artificial blood.

But I will not be detracted from my stoking,
gathering tiny fairy twigs and discarded birthday ribbon.
I am a swollen bonfire
belching a message to the sky:
There will be no scorched earth today.
No more clotted dirt and darkened eye.

I am so very, very busy.
You see this fire, your fire,
I will not let it die.

Rainy Beach Day.

Exactly two years ago I wrote these words in my journal:

Sarah is still clean.
It is a miracle.
Others are dying though. Dying everywhere at an unprecedented rate.
But we all die. I think about this at the beach and I cry with relief.

I think about these words. I don’t remember writing them.
Was I crying because my daughter was safe?
Or was I crying because death is our shared destiny
– and how can you fear something so natural?

I don’t know.

Today my daughter is safe after her relapse.
But today I do not feel relief.
Maybe it is the rain. Or the wind signaling the end of summer.
Or maybe it is something internal that I just can’t access.

It could be fear for the future,
or stress over the uncertainty.
It could be sadness for her struggle,
or anger at my being unable to fix it.

It is probably all of these things.  And more.  I know there is more.

One thing is certain though – today I will visit the beach.

The Art of Telling Stories.

I recently joined a storytelling troupe. This is a weird one for me since I don’t like being on stage. No one would ever describe me as theatrical. But this particular group shares recovery stories. Wishing to ‘end the stigma” I felt a moral obligation to sign up.  Plus, let’s face it, I have a lot of ugly stories in need of a facelift. Quite possibly this group could help with that. And there was a selfish reason; I was searching for people whom I could talk to. I’m not a recluse; I have some pretty awesome, long-term friends. But the whole friendship thing gets complicated when your child suffers from addiction. Most of the time, your friends just don’t ask. I had been forewarned ‘when your child suffers from a disease like cancer you get cards and casseroles, but when your child suffers from addiction you get silence.’ I found this to be true. Five years brought me one card, and no casseroles. Occasionally I did get to share my experience… but the exchange became too lurid even by my standards:

Mom #1: “X can’t seem to pass his driving test and he is so depressed. I worry about his self esteem.”

Me: “Y is sleeping in a filthy motel forty miles away using type A narcotics. I can’t sleep at night worried that she may be dying as I lay here in my beautiful bed.”

You can see the problem.

So you end up alone with your thoughts, either by choice or because people don’t want to engage in this kind of exchange (how are they supposed to respond?) But if not careful your sense of isolation can fester into a wound of resentment. You can’t help but wonder what friendship is really for. You start to feel buried alive: your once perfect family is now dysfunctional and your friends are psychologically absent. It can be a dark place to find yourself in.

This time when my daughter relapsed I decided things were going to be different. I considered asking for what I needed. But I just couldn’t do it. It felt like asking someone to love you… pathetic and powerless.

Instead I opened myself up to new avenues of expression. The arts take Courage and Power (uppercase letters intended). I am going out on a limb here… but I would venture to say that the definition of good art is that it is emotionally complex, it inspires conversation, and that it accesses the buried but universal elements of human nature.

As suspected it wasn’t easy to stand up in a room full of strangers and entertain, inspire and heal with a broken hearted story. One teller spoke of a day when she had sat at a table littered with jittery tinfoil scraps and the small rocks of crack she had been hoarding. She describes her apprehension when a strange man decides to sit opposite her. When he offers her a little blue pill to help her come down from her teeth clenching high, it is not the free pill that takes her by surprise. It is the impossible blue of his eyes. Suddenly the drugs became secondary to basic human connection. I could feel my head nodding. Connections can be made in the most difficult of environments. And the truth is that those who say you can “do it alone” are either misguided or lucky enough to not have been in too dark of a place.

One of the last storytellers spoke sadly of the loss of her marriage and self control to drug use. And of her dad’s steady effort to take her on long daily walks. On stage she mimic’d how her father, on these walks, would steal long wordless glances her way. It was all she needed; to be fully seen and quietly loved. To be fully seen and quietly loved – it is the only thing any of us truly need.  Life had taught me this.  And the arts gave me the means to express it.

 

 

Angry about (t)HAT.

I can’t help being angry about “HAT.”  HAT is the acronym for ‘heroin assisted treatment.’ A vocal minority is currently pushing for the legal prescription of heroin. Yes, you read that correctly. Before your head spins on it’s axis, consider that the aim is a noble one: ending death by overdose. Lives should be saved because the prescribed heroin would be pharmaceutical grade; not tainted by fentanyl, carfentanil, or any of the dozens of additives and poisons that can make up a street purchase.

HAT isn’t the brainchild of businesses trying to cash in on a future market (like WeedMaps, a California based online marijuana dispensary which is funding pro-marijuana lobbying groups in Massachusetts). Nor is it coming from those seeking lost tax revenues or the end of illegal street dealing and the crime that accompanies it. Instead it is voiced by those whose opinion should be highly valued: former addicts.  And by addiction counselors whose only motivation is saving the lives of their clients.

Disagreeing with such individuals gives me great discomfort.
But I feel strongly that HAT would be a mistake.

Prescribing heroin to an addict feels like giving up on them. (Would we prescribe bottles of vodka to an alcoholic so they wouldn’t drink antifreeze?)  These substances are KILLING them.  The ugly fact is that those who suffer from addiction are not going to quit until their life becomes unmanageable. Unmanageable may never come if we hand them their poison. The counterargument would be that HAT is successful in the Netherlands, Germany, Canada and Portugal. But they measure success by the decrease in deaths by overdose. You may have less death, but you may also have less recovery.  Isn’t recovery the goal?

Besides the ethical implications, there are practical ones, What sane physician would prescribe heroin? I can hear the counterargument: doctors have been happily prescribing oxycontin for decades so why stop now? While it is true that some willfully ignorant doctors bear partial responsibility for the opioid epidemic, most were deliberately duped by Big Pharma’s false claim that oxycontin was non-habit forming. Then, as an added blow to responsible prescribing, insurance companies tied doctor compensation to patient pain management (thanks again to Big Pharma’s funding of fake focus groups). But the past is the past and I can’t imagine finding a nation of doctors willing to prescribe what they should not have been prescribing in the first place.

HAT will have its supporters if the movement gets off the ground. One of them is certain to be the insurance industry. Did you know that heroin costs $5 a bag? On the other hand Vivitrol, a medication which blocks the effectiveness of heroin, costs $1000 a month. Which do you think your insurance company would rather cover?

I bet Big Pharma will also sign on for HAT. Why not get the green light to repackage oxycontin as heroin and continue to profit from the misery of others? I feel like smashing my t.v. on a daily basis when I see Purdue Pharmaceutical marketing their new pill Symproic to help opioid constipation. The joke is most certainly on us.

Possibly the biggest obstacle to prescribing heroin may be the addict themselves. As my daughter confessed “enough is never enough.” Will we have to continually increase the amount of heroin we prescribe as their tolerance increases? And if we do not will they trade their prescription for fentanyl laced street dope? My child told me that many addicts seek out fentanyl for the higher high. Let that sink in.

There is a saying that “if we could ‘love’ our addicts to health there would be no addicts.” There are so many of us out here, right now, seeking a quicker, better, safer solution. I know of a parent who drove their child to purchase heroin, waited in their car fitfully until they returned, and then watched them inject it because they needed to test positive for detox admission. Can you imagine being that parent? No one, no one, wants to be that parent.

Legally prescribing heroin….it feels like being that parent.

 

God Moments?

 

Someone in recovery described a story of mine as a “God moment.” They didn’t mean God, per se. They meant those moments when the universe just seems to be there for you. One of those rare times when the “dots get connected” when you least expect them to.

The moment I had been sharing was hardly ‘heavenly.’ It was about the time when my seventeen-year old daughter had prematurely left drug treatment and gone missing. A tip on her location had landed me in court to have her arrested and involuntarily committed for treatment. The judge issued a warrant that was due to expire at the end of that very day. As I sat on the court bench and waited for her arrival I had a distressing front row seat to a slow parade of sadness, ugliness, and desperation. What I did not witness was the arrival of my daughter. (A year prior police escorted her in both hand and leg cuffs. There is nothing more shocking than seeing your child shackled this way; other than realizing a year later that you are now looking forward to those same custodial restraints.)

With one eye on the ticking clock I asked the court officer for the address to the local police station. Upon arrival I informed the officers that I was about to “do their job for them.” They warned that my efforts would be wasted since ‘no one would open the door in a drug den.’ I countered that it was much more likely my daughter would answer if she heard my voice and, regardless, I was going whether they came with me or not. Possibly shamed, but more likely legally bound, they agreed to accompany me. That was when I learned that the neighborhood was so dangerous that a second cruiser was needed. To top it off I was given a lecture about “staying behind the officers” when we entered the building. (No God moments thus far… instead It felt a bit like we were prepping to enter the fifth level of Hell.)

The address led us to a street that was a lifeless shade of grey. There were dozens of people milling about but they morphed, understandably, into silent watching shadows. The triple decker we approached was adrift in discarded clothing, empty cans and bits of unidentifiable metal debris. The front door was located on the second floor and had no discernible way to reach it. No staircase, no doorbell, no mailbox, no buzzer. Together we rounded the building and discovered a dirty basement door boarded over with plywood and nails. I envisioned prying it open and crawling through the darkness. I made a note to return to this door if need be. Rounding the last side of the building we were greeted with an entry level, dead bolted, door. And a woman. The same woman who had been silently watching us from across the street. Earlier I had thought she was a man. But now I was close enough to make out the large breasts that hung to the left and right of her plain cotton tee shirt. She was powerfully built in denim jeans and construction boots. She had a plain round face, and a long thin black pony tail that hung down her back: pencil straight. Her countenance was unreadable. She pointed to me and, wordlessly, pointed to the third floor. I replied “yes.” She nodded and turned her attention to the large brass key ring on her hip. Methodically she flipped through dozens of standard cut keys and selected just one. And she opened the door. The next few minutes were a bit of a blur. I know we climbed to the third floor and we knocked and my daughter answered. The officers put her in handcuffs and she was wild with spitting fury. Even so, the officers carefully tucked my daughter’s dirty blonde head into the back of their cruiser. Before following them back to the courthouse I sat in my car for a moment. I didn’t notice that the woman had approached my driver’s side window until I heard the knock. Rolling down the window she spoke her first word to me. “Drugs,” she said. I nodded. Staring hard at me she then said “Bad drugs.” I replied, “yes.” Then she said, “good mamacita,” and slowly crossed the street.

It was only then that I remember feeling truly overwhelmed. Unhinged may be a better word. I had been playing this game for a few years but this feeling was different. I rolled up my window, but not without the self correcting thought “this is what you do in neighborhoods like these.” Yes, this is where my daughter was lost. But this is also where she had been found. Someone – someone I never expected to help me – had done so. The police hadn’t. What if she hadn’t been there? What if she didn’t have those keys? Why did she help me when she knew there was drug activity going on in a building she obviously had some sort of responsibility for? Why had she helped me in front of the cops? Was it a gift from one mom to another?

It was, in the end, a coming together of disparate parts of the universe.

Of course I felt unhinged. I don’t know if I experienced a God Moment. I don’t even know if there is a God. But I am beginning to believe I may have met some sort of fallen angel. A fallen angel who was working hard on our behalf. A fallen angel in construction boots.

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Sthira vs. Sukha

Sthira and Sukha are popular yoga terms meant to convey a “yin and yang” sensibility. I think of sthira as “roots” and sukha as “wings.” A more accurate translation of the Sanskrit would be “stability” vs. “lightness.” When practicing Ashtanga yoga I have always sought the sukha, or the potential to fly. I sometimes giggle aloud when my feet release skyward or my heart floats up to the ceiling. It is such a rare treat to escape gravity’s pull.

Sthira, however, is quite different – in many cases it requires the engagement of the larger, lower, muscle groups (the quads, the glutes, the abdominals). For two weekends now I have been reminded that stability is key. Scot, our instructor, has had us feel our feet, bend our toes, challenge our inner and outer thigh muscles…he even put us in cat pose and had strangers balance their bodies atop us in a form of improv contact. These undulating movements required constant shifting of my center of gravity in order to take someone else’s flight – or to entertain my own.

I thought I understood: ground yourself before you take off in flight!

Once again, I required re-direction. I overheard Scot explain that being actively grounded allows the upper body to be consciously free. “Active” being the key word.  Do not rest in your present position – but fully feel it for what it is (whether it be crooked floorboards, the push of another body against your spine, or the outward turn of your imperfect feet.) By doing this you are not actively seeking flight or lightness of being. You are instead grounding yourself to the earth and thereby engaging an interior reservoir of strength. Only then will your body feel safe enough to bravely reach upwards.

That is when the lesson sunk in. I have lived this lesson. For years I tried to create and recreate stable, safe footing for my daughter who suffers from addiction. I bounced between “Maybe I shouldn’t have said that. Maybe I should have said this. Maybe I missed something developmentally. Maybe a new school will work. Maybe a new friend circle. Maybe a new therapist. Maybe a new medication. Maybe exercise. Maybe more consequences. Maybe less consequences. Maybe a different insurance plan. Maybe, maybe, maybe….” I left no rock unturned. I needed her, us, to be free. But sukha was nowhere to be found.

I remember the moment when I finally accepted our situation. I was driving and the sun was setting and and my whole sense of being was flooded by the fact that my daughter had relapsed again. I didn’t know how to be. How could I just be with this? I remember breathing and releasing into that moment with a complete acceptance of the truth. It was dusk and the sky opened up before me and I thought, “this.” There is “this” too.

This acceptance, which I still feel vaguely uncomfortable with, was a long time coming. I had to fully acknowledge that change may not be possible – at least not in this present moment. This is not an easy thing for a mother to fully feel. But once I did I noticed the sky. It sounds so cliche – but at that moment I was fully awakened to the incredulous sky. I also understood this to be the second part of Scot’s admonition: to be consciously free. I chose to see the sky.

Since that day, nearly three years ago, I have looked upwards and found something akin to flight. And, incredulously, for two years my daughter has stood on terra firma.

We are free.