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.

 

 

 

 

 

 

I Wish I Could Be A Better Person.

I have seen addicts become better people than you and me. Those previously deemed selfish, sick, irresponsible, lost, criminal, hopeless.  Pick an adjective – at one point they all fit.  I know this sounds like pure hyperbole.  And to clarify, I don’t mean better than their old selves – that is obvious.  I actually mean better than you and me.

You and I, presumably, are the definition of good people.  We try to do the right thing on a daily basis. We live the Golden Rule.  But at the end of the day we close the curtains on the larger community.  We choose to be with just ourselves or the nuclear family we have created. We retreat to safety, comfort and self.

But the recovering addict doesn’t do that.

They often choose to mentor those who are still suffering severely – with little concern for the temptation that may present.  In the Big Book it is referred to as “giving back” or Step 12.  They claim that it helps themselves – but this, I think, is an overly generous sentiment.

I liken their behavior to that of a person surviving a fire… and then becoming a fireman. I don’t know about you, but I would never be that brave.

When those we love truly beat their addiction it can be hard to recognize them.
And it can be humbling to see that they have surpassed us in their ability to love and empathize.

For example, my daughter shares an apartment with three other individuals in long term recovery.  Their lease has expired, and two of them have decided to buy a home and possibly marry.  But even though this couple is ready for life’s next big step – they will not leave the other two women behind.  One could rationalize and say they are bringing them along to help pay the rent.  Until you learn that they are narrowing their house search to homes that can access the bus line.  My daughter is the only one of the four that does not have her driver’s license.  Purchasing a home within walking distance of public city transportation is of course more expensive.

And then there was the lesson I was given on Christmas day.  I had told my husband I wanted a pair of earrings made by a local artisan jeweler.  I wanted any color but blue – because, lucky me, I already had so much blue!  On Christmas day I opened my gift… and they were blue.  My face fell.  I didn’t hide my disappointment.  I even said “Ohhh… but they are blue.”

My daughter looked at me and said “but they are beautiful.” And later she said “Mom, you should have been grateful.”  She was right.  I had put my feelings (not needs!) first in a matter as trivial as that of material abundance.

I can’t imagine living every day weighing my psychological, financial and material needs on an equivalent basis with the larger community.  I had thought the Golden Rule was enough.  But the Golden Rule is based on seeing things through your own eyes – treating others as you would like to be treated.  But how about getting the “you” out of it?

Becoming a better person is within reach.  I know this because I have learned it from the recovery community.

I See You Mr. Double Standard.

I know many people believe that healthcare dollars should not be spent on those who choose to use street drugs. I get it. It’s about personal responsibility. Healthcare dollars are stretched enough caring for those who aren’t the agents of their own destruction.

However, I ask you to consider the following:

We cure cancer in those who continue to smoke cigarettes.
We staple the stomachs of those who ignore the food pyramid.
We perform heart surgery on those who have never seen the inside of a gym.
We given insulin to those who knowingly eat donuts.
We fix the broken limbs of those who practice extreme sports.
We pay for the delivery  of babies conceived by high risk mothers.
We stitch back the bodies of those who crash speeding cars.
We treat melanoma in those who refuse to stop sun worshipping.
We treat venereal diseases in sexually promiscuous people.

The costs incurred for treating these examples of “irresponsible behavior” are staggering: According to the Centers for Disease Control and Prevention, smoking is the number one preventable cause of disease in the United States and it costs $170 billion dollars a year in direct medical costs. According to the American Diabetes Association one in three medicare dollars are spent on treating diabetes at a cost of $322 billion dollars a year. And, “American use of tanning beds may lead to upwards of 400,000 cases of skin cancer annually.” (American Academy of Dermatology).

But you know what?  Those individuals receive treatment with care, efficiency, and efficacy. The same can not be said for those with substance use disorder. This time a year ago my nineteen-year old was turned away from a detox center because there were no beds. She then walked to Boston City Hospital’s emergency room, sweating and trembling, for help. They too turned her away. Desperate, she spent that evening trolling Mass Ave looking for the drug she needed to tide her over for one more day. The next morning she returned to both the detox center and the emergency room. And once again she was refused admittance. She called crying; “could I please, please help?”

Help should have been as simple as a request.

I spoke with the ER doctor. He explained, “we don’t treat drug addicts here.” He then explained that he would also not admit her for mental health reasons because he didn’t believe she “would kill herself.”

I felt weak at the knees. How does one mount a spirited defense when powerless?

“My daughter is only nineteen years of age. She is not yet a hardened street addict. She is high on a drug that is killing people at an unprecedented rate. She is asking for help. You are that help.”

Silence.

“We are not asking for charity. She is insured by two separate policies.”

His reply: “Hospital rules do not permit admittance.”

“Surely,” I argued, “it is time for hospital rules to change. This is an epidemic. Turn her away and there is a strong possibility that she will die tonight.”

Silence.

“Why wait for the hospital to change it’s policies in response to a dead child and a lawsuit?”

Silence

“You took the Hippocratic Oath.”

Silence.

“You could lie about the reason for her admission…”

Do you know how it feels to beg when you shouldn’t have too? Begging when the stakes are so ridiculously high?  It feels like swimming against the tide while trying to reach your drowning child. Swimming and swimming…and then the dorsal fin appears.  But hope is not lost: a lobster boat comes into view!  You yell for a rope. But they don’t throw one.   No, they don’t.  Instead, they sit back and watch.  Because, you know, she shouldn’t have been swimming in those waters.

I know I sound angry. That’s because I am.  I spend $1500 a month out of pocket for health insurance – and I have had to beg for life saving services.  Addiction is classified as an illness by the Diagnostic and Statistical Manual of Mental Disorders (DSM-III).   But the double standard most assuredly remains.

Triggers Are Not Real.

“TRIGGERS ARE NOT REAL.”

My daughter stated this, firmly, when I tried to stop her from taking a bus through a neighborhood full of triggers. Addicts are supposed to avoid triggers….just like someone on a diet should avoid a bakery, and someone thinking about a new dog should avoid a pet shop. It’s good common sense.

This particular neighborhood, for three years straight, had replaced days meant to be spent at school. It was where she met her first, of many, older, opiate-addicted boyfriends. The neighborhood where she drank with her girlfriends until they couldn’t stand up. The neighborhood she went missing in for nights on end. The neighborhood she partied in to the point of hospital intervention, repeatedly. The neighborhood with the drug store street corner. All of this would be within memorable reach.

“I don’t want you to take the bus. I can get you in the car.  I would be happy to come get you… “

“No.”

Trigger has to be the perfect colloquialism for “classical conditioning.” I appreciate the way it brings to mind the image of a loaded gun to the head. When you are the parent of an addict it becomes that clear. That person, that bent spoon, that ball of singed tinfoil, that street corner…. all become sensorial reminders capable of triggering relapse. And relapse is nothing short of a game of Russian roulette.

To be clear, my fear of triggers isn’t a case of playing probabilities or trusting in a predictable pattern of personal weakness. Classical conditioning is scientifically proven. Most of us are familiar with Pavlov and his bell salivating dogs. This early study in classical conditioning proved that a learned process can change a previously neutral stimulus into a potent stimulus. This potent stimulus in turn creates real biological change in the body. Biological change where none existed before. Replace Pavlov’s bell with a street corner and excessive saliva with irrepressible craving and the problem becomes all too real.

“I want to take the bus. Triggers are not real. Like, everything is a trigger. A song. A boy. The bathroom. The sunshine. A nice day. A bad day. Even the breeze. You have to deal with your stuff, mom. If taking a bus makes me relapse then I haven’t dealt with my stuff. You just don’t understand.”

I am trying to. Classical conditioning is not equivalent to the loss of free will. Biological stimulus does not have to be a siren call to action. We are a little more complicated than a bell drooling hound. But how difficult must it be to retrain our rewired and tired brains to see each situation clearly and non-reactively? Can we be our own psychologists, neurosurgeons, life style coaches and cautiously present Buddhas?

In the end, she took that bus. And you know what?
She made it safely home.

Trap Houses vs. Safe Houses

Those of you familiar with the language of addiction will know that I am not comparing domiciles that fail building codes with those that do not.

A trap house refers to a drug den. An abandoned property where addicts go to buy and use drugs for days on end. Think squalor. Think bug infested mattresses. Think quiet desperation. Think death.

“There is one way into a trap house, and one way out.”

A safe house is also a place for drug use. However you can not buy or visibly take drugs within. But you are expected to be actively high when you visit. Inside you are given the opportunity to swap out dirty needles for clean. And you may ride out your high in an upright chair instead of slumped on a dirty street curb. But most importantly: in a safe house you will not die. Nurses are present to monitor breathing, administer narcan, and call ambulances.

A Boston safe house opened in April after receiving support from the medical community, those who care for the homeless, Mayor Walsh and Governor Baker. Safe houses, or “safe injection facilities,” already operate in Australia, Canada, Germany, the Netherlands, Switzerland and Spain.

Still the idea of ‘state sanctioned drug use’ sounds shocking. The medical community refers to this approach as “harm reduction.” (Certainly a less charged descriptor!)

The immediate goal is to curb the alarming uptick in deaths; especially among the young.   On a recent trip to a town office building I found the bathrooms locked. The secretary explained it was to “keep the addicts out.” My daughter’s former boyfriend overdosed in a Dunkin Donuts bathroom. Afterwards he chose Burger King stalls. The reason? He had just scored in the parking lot. The newspapers are full of stories of addicts being apprehended inside their own cars in public parking lots, under trees in local parks or tucked down public city alleyways. It is hard to understand an addicts sense of urgency. It can not be compared to the Friday night joy of buying a bottle of wine, bringing it home, opening it up to breathe, and then swirling it in the glass. There is a sense of immediacy that most of us will never know.

Therein lies the problem. What will prompt an addict to walk to a safe house to ride out their high when they score blocks or miles away? If curbing the number of deaths from opiates is the goal, then heroin users will have to be allowed to use their drugs in the safe house – or right outside. Death from heroin, or fentanyl-laced heroin, occurs almost immediately. The drug is potent enough to shut down breathing within the first few minutes.

Of course we can’t allow safe houses to become “shooting galleries.” Or can we? Sometimes it seems like the most humane option… especially when you witness first hand the places where addicts live. Even more so when you find your own child in them. I ultimately feared finding my daughter expired on a street corner, behind a dumpster, or in a motel. I didn’t want her last moments to be spent cold, unloved, hungry, or abused. It wasn’t an irrational fear… it was only a matter of time. I considered bringing her home, knowing she was not ready for change, but wanting her to have the warmth of her bed and food in her belly. I was ready to wave the white flag even if she was not.

Could a safe house have been that sort of place for my daughter?

But safe houses do not allow you to sleep in them. And they do not feed you. They are not shelters without rules, or over indulgent mommys. In the end they could not have allayed my fears.

The only other North American safe house (a true safe injection facility) exists in Quebec. A medical study by The Lancet showed that thousands of lives have been saved: overdoses stopped, the spread of HIV/Aids minimized, counseling and detox services accepted. It is working, despite the usual NIMBY complaints.

Hopefully lives will be saved here in Boston. There is nothing more upsetting than stepping over an addict on the wintery streets of Albany and Mass Ave and “continuing on your way.” Now at least you can lead them to a warm, comfortable room where a counselor can ask them if they want help. Can offer them water. Can look them in the eye and take their blood pressure. A small amount of decency can be provided.

Time will tell. My only hope is that we have some hard science around the outcomes. No more moralizing on the one hand, or fear based preventive measures on the other. Since 1980 addiction has been classified as a disease. To a certain extent it angers me that we have come to this. Would we be considering safe houses if we had provided better, more efficient, longterm, quality care earlier to this population? I don’t know. But I guess we have to start where we are. And I can’t help but embrace a concept I would never have considered years ago.