parenting an addict

Ask Me

~ heroin heroine ~ 1 Comment

“Sometime when the river is ice ask me about the mistakes I have made. Ask me whether what I have done is my life. Others have come in their slow way into my thoughts, and some have tried to help or to hurt: ask me what difference their strongest love or hate has made.”

William Stafford wrote these lines. I found his slim book of poetry on a local library shelf. I had not heard of him, and wasn’t particularly looking for another man’s musings on the state of the world. In fairness I don’t know what I am looking for these days. But I opened the book up to the opening stanza of “Ask Me.” And I promptly felt assaulted by my own shortcomings.

Is the life i have led mine? Have I allowed it to be written by the circumstances I have encountered rather than the ones I have sought? Yes. How does one realistically go about firing the ghost writer if the ghost writer is your life’s circumstances?

The mistakes I have made…do I consider them? Not often.
Do I still make them? Repeatedly. Then why have I been so slow to address them? What if the mistakes are not the main problem, only ineffective stabs at solutions?

The friends who help – what difference have they made? And before asking that should I not ask myself, ‘have I fully allowed them?’

And of those who have hurt – did I forgive them too quickly? Or did I willfully forget rather than forgive? Was this the easier path? How much does it matter?

There is community. But paramount there is self. Looking at our collectivity can be a balm but rarely does it provide an individualized answer. Unless that answer is letting go with a passivity that destroys the still unacknowledged self. That, to this old self, doesn’t feel right.

What of the wonders outside of self? I can envision Stafford’s icy river disguising the current below. Stafford confidently states “What the river says, that is what I say.” Well what does the river say? Stafford explains “…the comings and goings from miles away that hold the stillness.”

It sounds so encouragingly whole – the river contains what has come before and what will come after. But the stillness, this ice, is it not nature’s attempt to stop forward movement? I realize it is a metaphor: a seasonal pause standing in for a human recess. But isn’t the ice also a disguiser, a preventer and a cold reminder of unchangeable currents?

No need to “Ask Me.” It has literally and figuratively all been said before.

Fires and Such.

~ heroin heroine ~ 2 Comments

Lately I have more time for solitude.
I’m not sure my mind and limbs are equipped for the change.
A good portion of my adult life they have been primed to put out fires.
My children, for the most part, have been the fire starters. Home grown arsonists. For over a decade they have been relentless in their attempts to burn their lives to the ground. And I have been primed to put a stop to that sh$t.

Honestly, someone should have made me a Smokey the Bear outfit by now.

Did you know Smokey the Bear was real? He was a three-month old black bear cub when he became a victim of the Capitan Gap Fire of New Mexico. His hind legs and paws were badly burned before he was able to retreat to the safety of a tall tree.

I am not saying I am damaged. I am not saying I have to be rescued.
But like Smokey, I am a little singed. And like Smokey, I have had a good perch from which to survey the surrounding damage.

And boy is addiction an effective fire starter.

I learned that addiction fuels most crime while sitting ringside at various Massachusetts district courts. At Quincy District Court, Worcester Court and Stoughton Court I noted that nearly all those being prosecuted for civil or criminal crimes had been under the influence of some sort of drug. Crimes like brutal fist fights, petty theft, grand theft, car crashes, spousal abuse, destruction of personal property, breaking and entering, prostitution and drug dealing.

It was an exhaustive, circular list. But each story had a name and a face. There was the elderly woman in crocheted clothing who used her cane to hobble up to the judge: how can she be in trouble when she couldn’t remember hitting that telephone pole while drinking? There was the young man pleading for a reduction in monthly court fees – he was doing well in probation but barely able to make ends meet after weekly sober home payments. There was the teenage girl in raggedy clothing trying not to cry over shoplifting. There was the middle-aged man explaining that he would never hit his girlfriend. But cameras had caught him doing just that outside of the local bar. So many people, so many problems. Victims of a disease perpetrating crimes making even more victims.

So what is the point of this post besides relaying misery?

Well from my vantage point I have learned about the existence of diversion programs. Diversion programs replace criminal incarceration with a series of tailored alternatives: usually drug testing, community support and service, and restitution (restorative justice) for damages. If one fails to follow through they return to traditional sentencing (a crime is a crime and accountability is necessary). But diversion programs work well – especially with juveniles. A 2023 study by the Massachusetts Office of the Child Advocate (in collaboration with DYS) showed a 69% positive closure rate. The Boston Bar Association (2018, v62 #4) showed a recidivism rate of just 16% and a 98% participation satisfaction rate as measured by offenders and victims. (Even victims!).

Unfortunately our family has experience with incarceration – without having committed a crime. Since my teen daughter could not stay sober she was deemed unsafe (which was accurate) and required lock-down supervision. Since no treatment beds were available at addiction centers she was remanded to Framingham State Prison. For five straight days guards laughed as she detoxed. Her days were then spent separated from the general population (explained as a safety measure) leaving her unable to exercise or move around the shared grounds including the library and eating areas. She was unable to reliably use the phone to make necessary calls for next steps (for example lining up a sober home upon her release). There were no AA meetings or therapy of any kind. She spent a month behind these bars. It’s worth noting that Framingham bills the state $160k per inmate, per year. If there’s a crime being committed it’s being committed by the institution.

Where does that leave us? With a burning field! But let’s be realistic: the field was always going to burn. It’s part of nature’s life cycle. And humans are always going to do the wrong thing – that too is human nature. But previously scorched fields can brim with new life. Diseased and damaged wood is fertile ground for new green shoots. Compost after all is made from decay – but to get the mixture right it needs a little tending. Those old promo posters of Smokey didn’t show this internal dilemma. After scrambling down from that tree he had a decision to make: stick around or flee to higher ground. His vantage point* must have taught him something. Because he donned that crisp new ranger outfit.

His catch words? “Care” and “prevention” and “personal intervention.”

*if you have difficulty envisioning the problem: visit your local court – it’s open to the general public. Take a seat and make a day of it. You can’t unsee the cyclical misery.

Where Everybody Knows Your Name

~ heroin heroine

The first time I walked into a peer recovery center I didn’t know what to expect. A woman i had become friendly with invited me. She was leading a group called “Faith Finders” which gave me pause. That and the fact that I was not in recovery. But I had met her in a storytelling class and kept bumping into her at the gym – so her vibe seemed to jibe with my vibe. And I like saying yes to most things. So I said yes.

The meeting was held on a cold New England evening. The parking lot fronts an active harbor and nearby cars were encrusted with a thin film of ice. When I arrived I grabbed one of the few remaining seats that formed a large circle in the room. I took off my bulky winter coat and placed it on the back of my chair. I snuck a summary glance and noted that, besides the host, I didn’t recognize a single person. This was unusual since I had lived in the neighboring town for twenty-five years. I tried to refrain my eyes from making continual rounds, but we were seated in a circle – so there was no empty spot to rest them. When the introductions began each person shared their first name, followed by “I am in recovery.” As I write this, years later, I can still feel how my body responded. At first there was an initial dulling of the senses (like a baby seal taking a whack with every name call) followed by a sudden infusion of thick, unsuspecting joy. Here i was, seated among a room full of people in long term recovery. Loads of happy, healthy, community-oriented people. Who the bloody hell knew? Certainly not me – and I had been seeking the possibility of such a future for my children for over a decade.

Since then I have been back to the recovery center countless times. I have attended a breath workshop, meditation groups, and for two years a weekly parent support group. I’ve tried acupuncture. I have danced at sober rock concerts. I also scheduled one-on-one meetings with the director where I asked him the most confounding questions like “why?” and “how?” and more desperate ones like”help her” and “help me.” No matter the question, he never batted an eye. Sometimes he laughed, sometimes he shared, sometimes he handed me resources. I always left in a better head space -which is saying an awful lot.

Did you know that center’s like this exist all over the country? They do! And even though my introduction began with a group called faith finders; a recovery center is nothing like a church. Its suggested avenues to wellness are varied. On the sidewalk outside our center a chalkboard invites you to try running club, yoga, book group, art therapy. There’s even a new Ted Talk hour. You may wander in unscheduled and ask for information on how to get yourself sober, how to get a family member sober or how to deal with people who refuse to get sober.

When your children are unrelentingly sick with substance use disorder you become, or at least I became, a weird version of ‘wildy blind’ and ‘blindly wild’. Sharing the unthinkable (how else to release it from ping-ponging around your brain?) and having someone with first-hand knowledge provide clarity (yes, there can be clarity!) is invaluable. And here’s the inherent bonus: recovery centers are manned by those in recovery. Suddenly the dying dream becomes a living possibility.

Oh I forgot to tell you how that first visit went.
When it came my turn to speak I just said “Annemarie.” No re-joinder.

And everyone welcomed me.

Mother’s Day Imperfection

~ heroin heroine

Mother’s Day can be difficult.
As a mother of three it feels wrong to admit this.*

Yet the last ten years have left me unsettled; even when treated to breakfast in bed and a chore-free day. All thoughtful for sure – but part of me feels outraged. As the years roll by the insufficiency of the gesture compounds. I know mothers are not supposed to be ungrateful and I am not sure that is exactly what I feel. I also know discussing this is breaking a golden parenting rule.

To be clear I am not complaining about diaper changing, house cleaning, grade monitoring, meal cooking or parent volunteering. Those things are par the course. Instead I am thinking about the additional job of parenting children with emotional issues and/or substance use disorder. These aren’t small add-ons; they are really, really big ones. Twenty years, and by my count, I have yet to drop “the ball.” I imagine this ball resembles a self-made rubber band one; constructed from layers of colorfully taut bands. Each band representing doctor visits, therapist visits, medical research dives, parent groups, medication trials, multiple schools, exercise regimens, courtroom scenes, police intervention, inpatient and outpatient hospitalizations. Then add layers of worry justified by dozens of 2 am phone calls, too many emergency room visits and hundreds of nightmares. It’s a pretty big freaking ball.

A bagel in bed doesn’t quell the unease this day can bring. Do I need to be congratulated for my super-sized role? I hope that isn’t what this is about. My kids are legally grown and the job of active parenting is no longer mine. But this day does incur reflection. What if, looking back on my parenting journey, I am presented with equal measures of both horror and joy? Maybe I am adding too much weight to the destructive part. But destruction always carries more weight doesn’t it?

When I look around I see a lot of mothers who seem to be pretty satisfied and duly feted. Am I comparing? I guess I am. it’s juvenile, I know. But it’s hard not to, especially on this day.

Sometimes I envision lying in a field and having people pile on top of me. It starts as one hug. A nameless, faceless person finds me alone in this immense field and gets down to envelop me. Then another joins. Then another. Layering on top of me like rubber bands on that mess-of-a-ball. I end up smothered (in a “smothered into stillness” sort of way). I can feel a tower of hearts beating on top of me. Although it becomes uncomfortable, it is a bearable weight. Does the dream personify my mothering experience? (Acceptance of the trapped nature of self buried under the leaden weight of my little slice of humanity?) Or is it instead my friends recognizing my distress and mercifully burying me in a form of living oblivion? I just don’t know. But a new Mother’s Day tradition may be called for. Something a little less pretty and a little less conventional than what has gone before. Maybe next year we should play tackle football. I can see it now: no one will follow the rules and everyone will want to win. We will struggle together and against each other. And in the process trample the hell out of my carefully planted flower garden. Maybe then this holiday will feel a little more honest. #vivathetruth

* I will be blocking my children from reading this: i may be ungrateful but i am not cruel.

The Ranking of Souls

~ heroin heroine

Many years ago my private school introduced DEIJ exercises (diversity, equity, inclusion and justice) during one of our teacher training days. It was a fairly new concept at the time and we prided ourselves on being progressive. It was my day off so I missed the initial session. I was told it began with teachers lined up in a straight line at the far end of a large green field. Questions were asked and if answered in the affirmative you took a giant step forward.

Questions like:
Did you grow up in a two parent home?
As a child did you have food security?
Has your family remained free of incarceration/justice system?
Do you feel welcome in most group settings?
Do you identify as white?
Did you receive a higher education?
Do you own your own home?

Yeses bred more yeses – exponentially. Looking around the field it must have been apparent that a secure upbringing reaped de-facto future benefits. Of course this was the reason for the exercise.

This part of the day I understood.

Later the teachers were handed a worksheet to rank whom they would choose to live with on a deserted island. People such as carpenter, doctor, professor, captain, Gilligan. Okay, it didn’t include Gilligan – but it did include two other distinct prototypes: violent criminal and drug addict.

I was told the drug addict came in last.

Logic must have escaped my fellow teachers. Who chooses to live with someone who is violent vs. someone who suffers from addiction? In a setting without laws or law enforcement why favor the criminal? And what kind of violent criminal are we talking about? If the crime was motivated by greed can they share limited supplies? If driven by power can they live within a democratic structure? Do they have a history of destruction of private property, assault, murder or rape? Do these tendencies evaporate on a deserted beach?

In all honesty, I wouldn’t rush to choose a person suffering from substance use disorder (SUD) either. The scientist, the boat builder, the storyteller – they have obvious benefits. But the person with SUD wouldn’t be last. Admittedly they can be violent: but it’s nearly always in pursuit of their drug. (Which, hello, makes it a non sequitur on a deserted island!) It is also true that active drug users are inconsistent contributors to a functioning society. But active addiction requires access to a drug.

At the time these exercises occurred my teenage daughter was in prison for her addiction. I was angry upon learning of my fellow teacher’s decision making process. It seemed curiously uncaring for a group of progressive educators. And if statistics ring true nearly every one of them knew someone suffering from the disease of addiction. Did they not believe in recovery? Could they not see the human inside? I understand the “eyes wide shut” response. Maybe they didn’t want to look too closely. And then there is the daydream of many a worn out caregiver: life on a deserted island! On this island we never bring our problematic family. We are alone, reading a book, tilting our noses to the welcoming sun.

I considered the human tendency to dislike in others what we dislike in ourselves. Many of us struggle with over-indulgence, keeping our word, consistency, making permanent lifestyle changes. So maybe it was as simple as not wanting to look at themselves.

I am not sure. I will never be sure. It’s too late now to go back and ask. And I don’t know if people would be honest with me. But I do know I was left with a vision: my daughter moving backwards across that green field; like a chess piece being cleared from the board. Thoughtlessly removed when she could still bring so much to the game.

Adult Woman Buys Self Teddy Bear

~ heroin heroine ~ 3 Comments

Buckled into the front passenger seat of my Honda CRV is a medium size teddy bear. The scruffy kind. His golden eyes stare dutifully ahead. Even when I hit snow drifts and his ear shook from the weight of his thick Vermont Teddy Bear tag: he remained resolute.

I bought him earlier today. At a pastel colored factory with a view of snow capped mountains and a sliver of Lake Champlain. When the little dark haired boy at the register asked me who he was for – I did not say for myself. But Bear knew he belonged to me. Upon checkout I stopped them from sealing him up inside a brown cardboard box. No worries, I explained, I can carry him out. As if I was environmentally conscious instead of emotionally needy.

I won’t name him beyond ‘Bear.’
Bear seems about right.

When my kids were little they called their goldfish “fishy,” their mouse “mousy” and their long-haired hamster “fluffy.” I used to laugh at what appeared to be a lack of imagination before chalking it up to language reinforcement.

We also had a gerbil called Blackie. (He was black, of course.) Upon returning home one afternoon my daughter and I stumbled upon an unfortunate scene. His little wire cage had been ripped apart, and he was being freshly spit out from our terriers mouth: his body wet and irreparably broken.

With both hands wrapped tightly around the dog’s collar, my daughter dragged her to the bathroom and slammed the door shut behind them. Rushing to listen, ear to closed door, I heard her say over and over “I forgive you, I forgive you, I forgive you – but you should not have done this terrible thing.”

My heart broke in that impossible moment.
To have such a little girl.

I look at Bear now and he tells me to stop being so sentimental.
He tells me that it’s just part of the stuff of life – like his own recycled cotton stuffing. Just another

Dog
Gerbil
Girl
Mom
Bear.

Waiting for Death

~ heroin heroine ~ 1 Comment

Death is the end of living.
All those biological processes – stopped.
It’s hard to imagine the blood stopping its circuit, the neurons no longer firing.
It’s easier to imagine the cessation of familiar parts of being –
No more rising belly breath, silly rambling thoughts or winter hands in need of warming.

It’s possible to imagine this in myself because I know my body, I know my age, I know the constructive and deconstructive properties of time and nature. I am nothing if not rational.

But death is not welcome to touch my children.
And what does one do if they dance with him continuously?
If they are not rational? If they do not value their youth or listen to reason?


Seriously, I am asking you: what does one do?

Hippy-Dippy Drug Days.

~ heroin heroine ~ 4 Comments

Do you remember when the local drug dealer was the high school kid with the chalk-painted Camaro who smoked during math class? Or maybe it was the friend twice removed who would set up lines of coke in shiny bathrooms of boom-boom-boom nightclubs? How about the neighborhood kid who rode his bike around town to deliver a mishmash of badly rolled joints? You would think to yourself, “Jesus Christ, am I the only one who knows what is going on around here?!”

Upon reflection, it really was kind of quaint. I am not trying to make light of drug dealing; but it was simple. It was local. It was a much naughtier version of the farm to table movement.

The latest way for teen’s to acquire drugs is through the snapchat app. Snapchat’s mascot is a small ghost: “now you see me, now you don’t.” Rather than being a cute play on peek-a-boo, it is meant to highlight the disappearing nature of texts. There is no paper trail, no electronic trace, no phone record…nothing to help you deduce why your child is writhing on their bedroom floor in a drug induced psychosis. Or worse yet, not even moving. This is a big problem for parents, and an even bigger problem for law enforcement.

One thing is certain: kids are still going to experiment. So absent a time machine, what are we supposed to do?

First, acknowledge the difference.

I have heard many parents say “It’s a rite of passage…I did it too in high school.”‘ Umm… no you didn’t. Marijuana in the 60s had a THC content of 2%, in the 90s it was 4%. Today’s weed is 200% stronger. THC derivatives like dabs, oil and shatter can contain THC content north of 95%.* Sadly, the higher the THC the lower the CBD content, and CBD has been shown to mitigate damage caused by THC to the brain’s hippocamus.** So if you are a reformed teenage pothead think twice before assuming your child’s brain is undergoing the same neurological “fun-fest.”

I am also surprised that parents willingly serve underage kids. Their justification? Learning how to “handle alcohol in my house is safer than the alternative.” But there is nothing safe about sharing alcohol with teens. Today’s research has proven there is a link between early drinking and a lifetime of addiction. We didn’t know it back then, but we know plenty about brain science now. We also know that parental disapproval is the number one reported reason teens put off drinking.*** (So why blow that safety measure?) Yes, some of us safely snuck a few beers in high school; but it’s important to realize that todays teens disproportionately binge drink. (Sadly, in my highly educated town, 17% of high schoolers reported binge drinking within the last 30 days.) Kids also have access to higher alcohol beers and very quaffable “fruit punch” flavored hard seltzers. Most of them have easier access to cars. It’s not as rosy as adult memories may suggest. So why romanticize it?

And let’s return to that teen smoking marlboros next to his camaro. It’s now a vape pen. Vape pens may not contain tobacco but they are still highly addictive and still contain cancer causing chemicals including VOCs, Diacetyl and formaldehyde. And realize that, just like marijuana and alcohol, our kids are getting “more bang for their buck.” A single e-cartridge is the equivalent of an entire pack of cigarettes. And they can be discretely smoked right in class – teachers can’t even smell them! Thanks big tobacco for developing a product that helps our kids avoid detention and comes in so many delicious fruit flavors!

For God’s sake the playing field is not the same.
So let’s stop saying it is.

* National Institutes of Health, National Library of Medicine, PMID: 30643324
** Harms, Protection and Recovery Following Regular Cannabis Use, pub.med.gov PMCID: PMC5068875
***NIAAA.NIH.Gov: publications/brochures-and-fact-sheets/make-a-difference-child-alcohol

Group Ghost Buster

~ heroin heroine ~ 8 Comments

Groups exist: running clubs and bird watching clubs, weight watcher groups and book groups. People join because of a common interest or to encourage each other in a common pursuit. But did you know that some people willingly join groups they do not want to belong to?! My husband and I belong to one. We joined a support group for those who have a family member suffering from the disease of addiction. We joined because “life had become unmanageable” and changing the behavior of our child was not possible. Instead we learned that we, like the others, are powerless. The common thread that binds us is pain.

Most Sundays a new face appears. We sit in a circle and each member gives an update on their addict; they are “doing well or back at rehab, homeless or paying rent.” We also share personally; we are “questioning our decisions, learning to not overreact, tired but hopeful.”

Why do we do this? There are therapists, on-line forums and self help books. There is also denial. Why meet to discuss the difficult?

I am not sure. But people tend to join when they are in crisis. The first step in the door is often a desperate one. They come for advice on what to do about a “missing family member high on alcohol and cocaine” or a loved ones positive tox screen for “benzos, fentanyl, crack and amphetamines.” We listen. We nod. There is a lot of nodding. There are no solutions. Instead we offer gentle suggestions or a new way of looking at the problem. It is strangely comforting to realize our ugly experience may be helpful to another – at a minimum by making them feel less alienated. A magical sort of alchemy happens when both hurt parties end up feeling a bit better.

When it is my turn I get to speak aloud the fears that have been echoing endlessly in my head all week. I liken this to opening up my closet door and calling out the ghost. Group Ghost Buster! My three-day headache dissolved after I shared one week. Why did the ibuprofen not work? I do not know.

You know what else helps? Getting lost in looking at my fellow group members.* I like looking at their shoes, their hands, their eyes, their hat choices. One wore pajamas two weeks ago! Some bring dogs. Some bring knitting. Others sit confidently. Some curl up a bit. I find it comforting to get lost in the visuals of our collectivity. Who knew this would be our reality? It’s akin to being dropped onto a strange new planet and having to assess your new mates. My husband’s verdict is that “he has never been in a room with more kindness and empathy.” I think he may be right. One member recently checked in with me via email. He signed off “you are loved.” (I cried then, and I am crying now.)

Ultimately, being in a group like this makes small talk impossible. Instead you must reach down to a deeper level to share the stuff that keeps us all afloat. I guess I should have nicknamed us Group Soul Buster. I encourage you to join one if you are in need.

*We now meet virtually. But I look forward to our in-person gatherings: for the shoes…and the hugs.

Public Service Announcement: Pressed Pills.

~ heroin heroine ~ 1 Comment

Pressed pills are counterfeit pills. And they are everywhere. If you are unfamiliar with them than you and I had something in common. We have all read about cash-only pill mills run by pain clinics. And individual crimes committed by those feeding an addiction: raided medicine cabinets, falsified prescriptions, doctor-shopping and faked injuries. But prescription pills no longer need to be hunted down because counterfeit ones can be delivered right to you. It’s an incredibly lucrative business. Consider that in the first seven months of 2020 the Minnesota DEA confiscated 46,000 counterfeit pills. That computes to 80K pills a year – in Minnesota – hardly a state known for its drug activity! If we were to use that same number and conservatively apply it to all 50 states, 4 million pills would have been confiscated. 4 million. Keep in mind that the police can’t find them all. Odds are there are upwards of 20 million illegal pills flooding our streets every year.

And most of us know nothing about it.

So what is a pressed, or counterfeit pill? They are pharmaceutical imposters made by drug dealers instead of lab technicians. They look exactly like the real thing in color, size, shape and feel. They even mimic the imprint code found on authentic medications. They look so real police are routinely fooled; unless you are transporting buckets of them in the backseat of your truck you are going to get by just fine – even if pulled over and asked to turn your pockets inside out.

But here’s the bigger problem: they are not what they purport to be. Pressed Adderall is comprised of methamphetamine, crack and speed; Xanax of ammonia, rat poison and fentanyl and Ecstasy of ketamine, bath salts and morphine. They may not be what you were originally shopping for, but they will get you high; and in doing so flood your bloodstream with highly addictive, highly deadly, substances.

How are they made? With a simple $500 investment on a pill press and pill mold. Equipment that is easily found on the internet. The profit on such an investment is six figures.* It’s no wonder it’s a burgeoning underground marketplace.

It’s seriously depressing. It is so monumentally hard to get ahead of the illegal drug trade. When one door closes (cutting back on the over prescribing of legal meds) another one opens.

I think back to a party I attended in 1984 at Vanderbilt University. I was a freshman experiencing my first frat party. It was wild. The music was blasting and the rooms pulsated with purple light. A few men wove their way through the crowd carrying large silver trays littered with pills. Pills of every color and size – free for the taking. I stuck to my beer. But plenty of others picked from the tray.

Here too one can get seriously depressed contemplating the ever widening scope of the problem. Yes, those pills pose a danger to those actively seeking them, but also to those who do not.

Richard Salter of Omaha’s DEA agency warns, “Please educate your high school and college-age kids on the extreme dangers of counterfeit medications, too often the overdose victims are young and are not prior drug abusers. They went to a party and someone offered them a pill to relax them – then they died. Too many American parents have had to bury their children as a result of drug overdose.” **

And so you have it: today’s public service announcement.

*March 2019 NABP, NADDI, and PSM
** DEA, Press Releases 8/12/20

*March 2019 NABP, NADDI, and PSM
** DEA, Press Releases 8/12/20

Summer Porch

~ heroin heroine

I have come to my summer porch to take in the late afternoon sun.
The old porch is hexagonal and has two squeaky wooden doors, two ripped screens and a weathered mahogany floor.

In one corner I spy a robust little pile of mouse droppings. They betray a foolishly circuitous trail; a rodent’s version of the Hansel and Gretel tale.

Under the small wrought iron table I find two soft grey feathers. Feathers like those from the breast of a grey catbird. They lie discarded, side by side.  I can’t help but hope that she didn’t struggle too long before finding her way back through the opening in the ripped screen.

Around the old iron table sit four bright yellow chairs – one of which has a long black hair entwined tightly around a securing strut.  Was it yanked from the head of the person because they rose too quickly? How long has it been there?  Why do I not remember having a visitor with such long black hair?

And as I write this an electric green dragon fly encircles my big toe.
I want him to light down on my blue painted toenail. My mind silently chants “do it, do it, do it.”  He chooses not to heed my psychic call.

So now I turn my gaze to the hummingbird feeder. I have filled it with sweet sugar water in just the right enticing ratio. But no one has visited yet this year.  I used to have a visitor. He would frequently hover just inches from my face. We would study each other. The sound of his frantic wings would fill my ears and I would worry about the short distance between his beak and my eyes.  But it was always thrilling.

I googled Mr. Hummingbird’s repeat visits. It had to mean something, right? What I learned was that Native Americans believed a hummingbird was sent as a reminder to live in the moment.

I can see now that I have both missed moments and tried to control moments. And I am still doing both. I came here not to witness mid-summer beauty, but to distract myself from my preoccupation with wishing for another’s wellness. The nagging truth is that a wish, no matter how badly one wants it, does not create reality.

How can such a lovely thing, a wish, be also such a sobering thing?

As I write this I realize I have not learned a thing.  I flex my painted toes and scan the yard.  I am still waiting for that little green hummingbird to visit me again.

Paper Airplanes of Love.

~ heroin heroine ~ 3 Comments

Everything is a love poem.

Someone said this recently.
I think they were joking because their tone was a bit flippant.
But after he said it he let a long pause hang in the air.
And the pause felt like a challenge.

I guess I would like to believe that everything is a love poem.
I admit I embarrass myself. Am I just a silly girl?

Yet there is a whole lot of love tucked into nearly every day: A smile from a stranger, the cat that follows you down the driveway, the extra cheese someone put on your sandwich, the feel of the wind on your cheek, an evening swim, a pink sky, music on the radio, cold ice in a drink, the feel of a warm embrace. Right now my big old red dog is laying down under a tree and sniffing the air. If he catches me looking at him he will feel the need to come stand by me, and in doing so he will have to move his arthritic hips. I look quickly away so he will not struggle. Love, love, and more love.

Of course we can’t dismiss the broken hearts, the divorces, the deaths.
Yet these hurt because they showcase another side of love: the loss of it, the memory of it, the importance of it.

Then there is self love. Contrary to what our media feed may tell us self love is not a day at the spa or a healthy meal delivery from an internet box service. True self love depends upon unconditional love.

The first time I considered the meaning of “unconditional love” was after a text from our family therapist. She implied that I might have been lacking it. She sent it upon the aftermath of my umpteenth midnight run to pick up my screaming daughter from a police lock up. The therapist was wrong. Nothing my child did or said could have made me love her less. I was just not willing to equate loving her with letting her go. I was not willing to “live and let live.”

Sometimes I criticize myself for all the time spent “loving” her – often at the expense of the other members of my family, and my own. (If you think you are hard on yourself ask a mother of an addict how she feels deep down inside.)

I had a fabulous therapist for a year who asked the most ridiculous questions: what kind of wild animal did you see today? what is your love language? But she was also spot on. She brought me back to the love that was all around me (that old dog under the tree, that cheese on my sandwich, that pink sky).

Unconditional self love, however, is a strange concept. We misinterpret it. We think a self improvement regimen is as an act of self love. Or we recite our strengths to feel worthy of it. But self love requires something completely different. It requires accepting that mountain of other, quieter, stuff; our operating quirks, our bias, our mistakes. That mountain grows as we get older. Maybe that is why so many of us address it later in life.

My New Year’s resolution is to take time to sit quietly.   To sit quietly atop my mountain of stuff.  And I am going to write some love poems.  And I am going to let them fly.

Blue Puzzle Pieces.

~ heroin heroine ~ 5 Comments

I was watching a pretty horrible rom-com movie the other night that had one redeeming moment. It was when the female told her heartbroken friend that he was ‘broken apart like a puzzle and needed to search for the blue pieces.’

Now this seemed like pretty bad advice. Putting together a puzzle involves seeking and creating distinct subject matter piles: the farm house, the feathers, the tractor. The blue ‘filler’ pieces, like the sky and the ocean, are chosen last.  (Why would you eschew the obvious for the nebulous?)  Clearly the puzzle comment was a metaphor; but was she actually advising her friend to find himself by looking outside himself?

I thought of my daughter. In recovery she has found success looking outside herself for stability. She has learned that arranging and re-arranging, ruminating and re-assessing the pieces of self is not always productive. Turning her attention to something bigger, something out there – like the sky – can be the best anchor there is.  It becomes an intangible you can neither wrangle with nor second guess.  You can rest in its remote vastness.

She often sends me pictures of the mountains she climbs. And the rivers she runs beside. And I download these photos to my iPhone. I look at them occasionally – they have become my blue pieces.  I feel this is both wrong, and right.

We spend a lot of time as mature adults concentrating on the subject matter of our lives; paying for and tidying the concrete spaces we have built. When we find time to consider the blue pieces – how often do we notice if they are truly our own?

 

Time is Not Golden.

~ heroin heroine ~ 10 Comments

 

Broken things can be mended. Like my coffee mug with the reattached handle. And my old cashmere sweater with the stitched moth holes. Broken things can also just be broken. Like my refrigerator which is currently leaking all over the kitchen floor.

You probably know where this is going. This is a blog about recovery after all.

I like to remind myself that broken things can be fixed. I am sitting at a round oak table that I found in the bowels of an antique store. The owner practically gave it to me when I said I liked the shape of it. I brought it home and stripped it, sanded it, stained and polyurethaned it. It is heavy and beautiful and has the most glorious curled feet. For so many years it sat in the basement of that shop covered in green paint. You couldn’t even see those strong, lovely feet.

But recognizing an objects worth and fixing it are sometimes not enough. The motherboard on my refrigerator has been replaced yet the temperature continues to rise. I defrosted a frozen drain hole and the ice block returned.  I superglued the fraying rubber gasket – it ripped some more.

People can be broken too. But unlike objects, people are not irreparably damaged.  Yes, some may have been born with “operating quirks.” Some continuously fall prey to their own bad choices. And some peoples broken-ness can be blamed on others.

The Japanese term for embracing imperfection is called “wabi sabi.”  I like this philosophy; I find delight in crooked teeth, aging faces, scarred body parts.  Who really wants airbrushed perfection?  But admittedly some things are not just worn, but broken.  The Japanese have a solution for that as well:  kintsugi.  Kintsugi is the practice of using gold joinery to reattach broken pottery. Gold joinery to illuminate imperfection!  The resulting pieces are a work of redemptive art.  Like my round table.  Like the people I have met in recovery.

But how come some people never make it to that redemptive place? I believe it is simply a matter of running out of time. The time needed to be pulled out of that “dark basement,” the time needed to have their broken-ness acknowledged, and the time needed to reassemble themselves.

Today I am thinking of all the lovely people who ran out of time.  When I was little my father would ask me “what kind of wings would you like when you become an angel?… gold, silver or copper?”  (Disclaimer:  my dad never believed in Christianity. He was most likely drawn to the Pre-Raphaelite imagery.)   I always answered copper. I preferred the warm shimmer.  

I know this is a silly wish – but if there is a heaven, I hope that when I arrive the golden wings are reserved for the broken people – the ones who either fixed themselves while on earth or were mercifully repaired when they ascended.  Kintsugi Angels.  

Amuse-Bouche

~ heroin heroine ~ 2 Comments

 

An amuse-bouche is a single, bite-sized hors d’œuvre. You do not order it. Instead it is chef chosen. A single earthy escargot. Tuna tartare wrapped in a crispy beet slice. An heirloom cherry tomato filled with lemon infused goat cheese. You get the idea: a tiny surprise that packs a big punch.

Amuse-bouche: it has a nice ring to it. It’s advantageous to have a fancy pants word in your back pocket for use at corporate back-slapping parties and such. But its use is kind of limited. And it’s a shame to have a good foodie word go stale. What if we applied it in a broader sense?

A successful amuse-bouche is more than a single yummy morsel. It’s a clue to the ‘taste direction’ of the rest of the meal. It’s basically the “divining rod” of the unfolding culinary experience.

What if we asked ourselves what small moment, or amuse-bouche, has predicted our life’s path thus far? It can’t be a moment we were responsible for; like choosing the late train home and inadvertently sitting next to our future spouse. Instead the moment has to have been presented to us. A tiny morsel that, if we were paying attention, forecasted the unfolding of future events.

If you had asked me a few weeks ago what my amuse-bouche had been I could have come up with a half dozen. It might have been how my youngest daughter did not like to be held close when she was an infant. Instead she liked the isolated confines of her car seat. In response I took to putting her in a snuggly every evening and walking up and down the streets of our small town with her firmly affixed to my chest. I figured it was a way to give her the best of both worlds. This small moment now appears a microcosm of our larger struggles; hers to uncomfortably retreat and mine to forcibly show maternal love.

I might also think back to how she wanted to fill her crib with large plastic toys – rocking horses and dump trucks. I would ably assist: You want this one? You want this one? She would grunt and nod and only lay down her head when she was nearly buried alive. For the next twenty years i would become a witness to her unconventional, and frightening, methods to self soothe.

Another “amuse-bouche” could have been her night time ritual. Instead of singing ‘twinkle, twinkle little star’ she would tick off a long list of potential disasters on her tiny little fingers. With her eyebrows stitched tightly together she would recite “house fire,” “tornado,” “molly-dog dying.” When I would ask her to please stop she would insist on continuing because “if she said them out loud they would not happen tomorrow.” It was like watching her conjure up the prop gun at the beginning of a movie. The prop gun that always portends disaster. As adults we know there is no wishing away the bad stuff.

But none of these were my true amuse-bouche moments.

I learned this after hearing a friend speak uncomfortably about her down syndrome sister and the family burden it had created: their father abandoned them and her mother became consumed with her care. This friend smiled recalling how she and her sister would play simple card games over and over and over. She didn’t recognize that her “amuse-bouche” had not been the birth of her sister. The card game was. The words “over and over and over” were the clue – they highlighted what was to become her signature strength: patience and empathy.

Her story was a reminder that our amuse-bouche moments are not the big things. They are not the burgeoning substance use disorders and the undeniable disabilities. They are much quieter, much more subtle. A chef would explain that it is not the oyster itself – but the taste of the brine.

I know now what my amuse-bouche has always been. It was the kindness shown to me by my eldest child when she was just a toddler. I had been lying in my bed, crying. It was nothing more than new parent exhaustion. But she got herself up from her nap and toddled her way down the hall to check on me and with her little hand on my back she gave me tiny pats. And then she offered her pacifier to me.  She was comforting me the only way she knew how.

How could I have nearly forgotten that one amazing moment?

An Augusten Burroughs Kind of Dream.

~ heroin heroine ~ 2 Comments

 

I had a strange dream last night.  In this dream I tried to help someone (a confident yoga teacher) find something in a dark basement. I ran after him to help because I knew it would be very dark and very dangerous down there. But he shut the door on me. And I was left behind in a room full of beautiful, happy, healthy people. It was then that I felt the arch of my foot throbbing. Refusing to acknowledge the pain only led to it increasing and traveling to the top of my foot, my ankle and my calf. When it became nearly unbearable I looked down to find swollen blackness had encased my lower leg like burnt elephant skin. I recall thinking, “This is okay. You can handle this by ignoring it some more.” Just then a partygoer with a handy pair of scissors grabbed my leg and started cutting the damaged encasing away. I was semi-terrified but decided to trust them and was surprised to feel no pain as the damaged skin fell away in sheets. I watched as my leg emerged – pale, healthy and pain free.

I think I know what this dream is about.
It’s about opening my eyes to the constant need to close them.
It’s about learning to let others fend for themselves.
It’s about cutting away the things that bring me pain (not to be confused with ignoring things that give me pain!)
It’s about trusting others to help me.
It’s about re-claiming space with the happy, healthy people.

This is the perfect sort of dream for a mom of a child in recovery to have.

It’s funny how our subconscious sends us freaky night time missives and our waking mind attempts to make sense of them. Of course I can read this dream many ways. Possibly I should be more humble – who do I think I am that I can help an athletic male yogi avoid danger? Or maybe I am simply being reminded to run a little less so my foot doesn’t throb in my sleep.

Or possibly my brain is sending me the naughty subliminal message to get in with the type of people who run with scissors.

🙂

Poetry. Addiction. Life.

~ heroin heroine ~ 1 Comment

Poetry. With just a few words it can make the most difficult feelings easily understood. Or it can transform the most mundane activity into a deeply humanistic ritual. I used to think poetry stripped things down to their basic essence but now I think it has the ability to alchemize life.

There is a belief that the creating artist suffers more than the rest of humanity. I do not believe this to be true. I had a Harvard professor (shout out to Vernon Howard!) who once said “one man’s opera is another man’s ball game.” He wasn’t merely being democratic – he was speaking the truth. Every day I am humbled by the breadth of artistic expression.

One artist I deeply admire is the Iranian born poet, Kaveh Akbar. I hesitate to explain what he means to me beyond revealing that he is in recovery and that his words seem to both inform, and include me. Miraculously he incorporates multitudes* in that his everyday language builds an opera of understanding around what it means to suffer, to dream, to survive.

 

RIMROCK – by Kaveh Akbar

Without the benefit of fantasy
I can’t promise I’ll be of any use.

Left to the real world I tend
to swell up like roots in the rain,

tend to get all lost in hymns
and astrology charts. Lately

I’ve been steaming away, thin
as cigarette paper, cleaning up

the squirrels that keep dying in my yard.
Each cascade of fur feels like a little tuft

of my own death. Am I being dramatic?
Mostly I want to be letters—not

their sounds, but their shapes
on a page. It must be exhilarating

to be a symbol for everything at once:
the bone caught in a child’s windpipe,

the venom hiding in a snake’s jaw.
I used to be so afraid of nature.

Peering up at a rush of rimrock
I imagined how unashamed it would be

to crush even me, a tiny stuttering boy
with glasses. I pictured myself

reduced to a warm globe of blood
and yearned to become sturdy in my end-

lessness, to grow heavy and terrible
as molten iron poured down a throat. Still,

I don’t know the rules. If I go looking
for grace and find it, what will grace

yield? Broken ribs, probably, flakes
of rust, an X marked in an atlas which itself

has been lost for ages. Oh, but I do
know what I am: moonstruck, stiff

as wet bamboo. I remember someone
once sang here, once strung together

a garland of near-holy moments.
It’s serious business, this living.

As long as the earth continues
its stony breathing, I will breathe.

When it stops I will shatter back
into gravity. Into quartz.

(*with another shout out to Walt Whitman’s Song of Myself.)

“ACE” made me do it.

~ heroin heroine ~ 2 Comments

There is a relatively new addiction model called Trauma Therapy. One of it’s chief proponents, Dr. Gabor Mate, explains that people are born perfect and adverse childhood experiences (ACEs) create trauma which leads to addiction. In an interview in The Fix Mate claims, “if children receive conditions of love and respect in their childhood, they’ll never be addicted, they’ll never get depressed and they’ll never be anxious.”

What qualifies as an ACE? Physical, sexual or verbal abuse, physical or emotional neglect, living with a parent who is abused or addicted, having an incarcerated or mentally ill caregiver, or suffering the loss of a parent through divorce, death or abandonment. The Centers for Disease Control developed these markers to identify people at high risk for obesity, depression and addiction.

According to Mate all IV drug users score positively on the ACE scale. Furthermore he insists if you do not recall childhood trauma then you are repressing it and in need of extensive “trauma therapy.” (If this is not a siren call for false memories then I don’t know what is.)

I shared my doubts with a follower of Dr. Mate. I explained that my child did not meet a single marker on the ACE scale. Stymied, they asked if her childbirth had been traumatic (which felt a bit like “mother blaming”). When I explained that she was the easiest of my childbirths I was told my daughter must be a victim of epigenetics. This was explained as “inheriting on a cellular level the trauma of previous generations.” I was then asked if something ugly could have happened to me as a child, something that I may not even recall. A subconscious molestation could be the reason I birthed an addicted child.

This does not sound like responsible science to me.

Epigenetics is the science of gene expression. It explains how the environment may turn on/off the expression of certain DNA coding. For example there is scientific evidence that extensive stress can cause permanent damage to the body’s production of cortisol. This makes sense since we are biological beings and our bodies interact with, and are affected by, our environment.

The proponents of an epigenetic basis for addiction cite work done by Rachel Yehuda Ph.D., at the Icahn School of Medicine. Dr. Yehuda hypothesized that genetic damage suffered by an individual could be passed down to future generations. She deduced this after finding an increased rate of anxiety, depression and obesity in the children of Holocaust survivors. She attributed their health problems to inherited faulty cortisol production and enzyme regulation; rather than asking if growing up with PTSD-affected parents could have produced an environment that fostered stress in the children.

It is important to note that Dr. Yehuda’s work has been debunked. The Chicago Tribune (citing various sources) reported “Yehuda’s study began with too small of a study size. Only 32 survivors and 22 of their offspring were studied. That’s a very small group on which to base this theory and a major study flaw.” The article further revealed a major flaw within Yehuda’s research: “While the team studied the children of women who lived through the Holocaust, they would have to study the great-grandchildren of survivors to prove actual epigenetic inheritance from mother to offspring. Why must four generations be studied? The eggs that made you were present inside your mother when she was a fetus inside your grandmother. Because a pregnant woman already possesses the DNA of her grandchildren and these genes can be affected by things during her pregnancy, the DNA of the great-grandchildren has to be studied to show that epigenetic changes were passed on across generations.”*

I also can’t help but think that if generational trauma was a prescription for drug abuse the species would be extinct by now. The circle of damage would have increasingly widened as generations multiplied exponentially through time.

Strict reliance on ACE is problematic on another level: it rigidly shuts the door on other causes of addiction. Purdue Pharma flooded the market with highly addictive pills that have been proven to change neuro-pathways in the brain. Are we really going to insist that those who got addicted did so because of early trauma (divorced parents possibly?) and not because they were the victims of corporate greed?

Interestingly Mate acknowledges that “not all of those who have ACEs become addicts, but all addicts have ACEs.” Why isn’t Mate questioning this discrepancy? Could the difference be attributed to the fact that some people are genetically predisposed? Or that they have less emotional resiliency because of a psychological disorder that is eased by substance use such as anxiety, bipolar, or depression?

Dr. Mate insistence that psychological disorders are created by early trauma is nonsensical. Babies are not born perfect! Every day children are born deaf, blind and lame. They have congenital heart defects, they have sickle cell anemia. To think that the newborn brain is inure to imperfection is ridiculous.

Imperfection is part of nature. I often ask my art students to go outside and find the perfect tear shaped petal, the perfect circular rock. They always come back empty handed and we marvel at the impossibility of it. It is only the foolish or megalomaniacal who dream of perfection.

My daughter is flawed – but not any more than me. She is stubborn, I am prideful. She is anxious, I have self doubt. She did not have a traumatic childhood; she had a fairytale one lived out in a house near the sea with a sister, a brother and a big fluffy dog. She tells me nothing untoward occurred during her formative years and I believe her. Can she benefit from trauma therapy? Of course. But it would be for trauma experienced while using.

Mate’s proposition is maddening because it is reductionist. And because it asks people who are already suffering to seek another layer of pain where none may exist. It also demands that science take a back seat to a condition that people are finally beginning to accept as a disease.

I feel traumatized by the possibility of it.

Stats… STAT!

~ heroin heroine ~ 7 Comments

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.

~ heroin heroine ~ 5 Comments

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.

~ heroin heroine ~ 2 Comments

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.

~ heroin heroine ~ 5 Comments

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.

~ heroin heroine ~ 4 Comments

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?

~ heroin heroine ~ 2 Comments

 

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

~ heroin heroine ~ 4 Comments

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.

~ heroin heroine ~ 7 Comments

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.

Watching Someone Die in Ohio

~ heroin heroine

Once again I am reading of yet another police department bemoaning the fact that they have to use a nasal spray (Narcan) to reverse the fatal effects of an opiate overdose. Just last week Butler County Sheriff, Richard K. Jones, prohibited his officers from carrying Narcan by explaining “here in Ohio, the (paramedics) get there about the same time and they’re more equipped to use Narcan. Requiring deputies to administer the medication puts them in danger.”

While true that Sheriff Butler is in the midst of a maddening epidemic that is exhausting and frightening – his explanation is nonsensical.  Why would police officers allow paramedics to deal with people who, in his words, “turn violent once they are revived?”

Sheriff Jones further complains that this epidemic is “sucking his taxpayers dry.”  Jones next move may be to follow the lead of fellow City Councilman Dan Picard from nearby Middletown, Ohio.  Picard has requested that ambulances no longer be dispatched to previously revived people. (In fact, he would like those overdosing to be fined – on the small chance they survive without assistance.) Now here is a move that would doubly benefit the taxpayer!

What we are hearing, (if not job exhaustion accompanied by bigotry), is a need to revisit the department’s mission statement. It is not uncommon for large organizations to have to remind themselves of their core mission.

Most police officers are hired:
-to mitigate damage and destruction of property
-to defend and protect individuals in the community
-to operate as first responders*
*Contractual footnote: most stipulate a speedy emergency response even to multiple calls from the same individual – you do not get to choose who you respond to. Also, those served aren’t required to be instantly appreciative or futuristically compliant.

Those of us who parent addicts understand the frustration. We know they don’t listen. We know they go back to the drugs. We know our efforts are often ineffectual. Over and over again – the same honest effort, the same disappointing result. But confer further with those of us who are not in a position to “give up” and we will tell you to trust in that future day. Not all will be saved because no epidemic-sized rescue mission will ever be 100% effective. But the recovery community is surprisingly large. Imagine the day when the person you revived is healthy and whole and breathtakingly alive. Imagine you made that possible by the simple application of a quick acting nasal spray.

Now, imagine differently. Imagine you arrive at the scene. You see the boy you saved last week. He is blue. You try to ignore his crying parents as his breathing slows to a stop. You mumble under your breath “not my problem” because this time you are not permitted to expend any life saving measures. You console yourself that the boy willfully took the drug. Possibly it will feel like witnessing a goldfish jump out of its bowl and quietly allowing it to suffocate.

I imagine that Sheriff Jones forgot one crucial element in his cost-benefit analysis: the mental health of his responding officers. Did he consider how they might feel responding and choosing not to serve? Not to rescue? Not to mitigate the damage? Not to call forth compassion?

It is one thing to be tired of saving the same people over and over.
But it is quite another to watch them die.

The Power of Words

~ heroin heroine ~ 1 Comment

“I am an addict. I fucking love shooting heroin. I love it. You would love it too if you tried it.” – My daughter, April 13, 2015, calling home from Arbor Hospital in N. Attleboro

Until I heard these words I had not fully believed she was an addict. I thought depression, anxiety, poor impulse control and the wrong crowd had led to a misuse of substances. But addiction? To heroin?

The next day she refused further treatment and checked out of the dual diagnosis facility the ambulance had transported her to just a few days prior. The power of her spoken words just a memory. How could they let her leave? Why would she choose to leave? She called once more explaining that she would be staying with an unnamed girlfriend in New Bedford: “There won’t be any problems. She will teach me to drive. There is a community college nearby. I will go to a Suboxone clinic.”

Who was this mystery person who would house my homeless daughter? How can you practice driving without a permit? How can you go to college when you dropped out of high school? How can you start a new life in hospital scrubs? All those motherly questions remained unanswered.

I wanted to believe this new friend was safe; but her last “safe” roomie was dead. Do addicts believe the yarns they spin?

Then my texted treatises begin. I had become as manic and as lost as my daughter. I warned that she couldn’t live a happy, healthy life on dope. I explained why “home is not an option,” and I begged her to reconsider treatment.  I feared her death and every morning I asked myself “will this be the day?”  I didn’t want her to leave this world hating me or not seeing a way out of the paper bag she had put herself in. I wanted to clear the mind debris; hers… and mine.

But my words got no response. Eventually I just texted that I loved her unconditionally…. even if she couldn’t kick this. Each time I wrote it I felt like I was signing a death warrant. But we all die. But not all of us die feeling loved.  I wanted her to know that her mother would always, always love her.

For weeks upon weeks I got no reply.

My daughter was a young adult of nineteen years. The law, the courts, the healthcare system all had decided that it was none of my business. My sick child was now the captain of her own ship.

After a month or two – I received a reply. She did not tell me where she was. But instead wrote, “you will always be the greatest mom in the whole wide world.”

I did not feel grateful. Instead, I felt sick. My daughter was now doing the equivalent of what I had been doing: making sure all of our interactions were kind because we may not have many left. I knew her words would save me if the worst came to pass. But I did not want to hear them.

This disease is so heart achingly difficult to process that sometimes silence gives more comfort than words. And how does a mother find comfort in that?

 

What Am I Here For?

~ heroin heroine ~ 1 Comment

 

My husband says it was to save our daughter. I have saved my child. At least twice she was within days of dying. But is this all I am here for? I can’t keep her alive if she doesn’t want to be. Hell, I couldn’t even keep her alive if she asked me too. In the end, the work necessary for survival is hers. I can’t do it for her. And saving your own child isn’t magnanimous. It is what most of us would do. And, more importantly, it is what we should do.

Doing what you should do can not be a life’s purpose.
And we are all bound to fail if the purpose is following some sort of moral script.

Sometimes I wish we could all be avengers and superheroes; performing spectacular feats of a magnitude that we never predicted on our little home radars. Why can’t the tiny ripples caused by good deeds be more like tsunamis?

There is an urgent need for a lot of saving to be done.
And sometimes I just feel plain powerless as I sit here eating my lunch.

What “War” on Drugs?

~ heroin heroine

“We lost more people last year than the entire Vietnam War and Korean War combined.”

I received this text on a frosty Sunday morning from a friend who is a cardiologist. He can not ignore the obvious. Every emergency room bed is filled up and down the East coast. Patients line the corridors in gurney traffic jams.

So how are we addressing this home grown war of epic proportions?

JP Clark, West Point professor and author of “Emergence of the New Modern Army,” explains that the US military prepares for war by planning during peace time. Makes sense.

The US has spent a lot of money, and time, attempting to stem the flow of drugs and incarcerate dealers. I am not opposed to either effort – but it has been a one-pronged enforcement driven approach. Notably; the drugs have not been contained. They continue to cross the Mexican border, and be flown in from China and Afghanistan. But before preaching isolationism consider the role of American pharmaceutical companies and script writing doctors…

According the to the Nat’l Institute on Drug Abuse, 80% of all heroin users began their addiction with access to a legal opiate prescription. Let me say that again. 8 out of 10 American youth are shooting up, stealing, selling themselves and dying because they had access to a legal prescription. Prescription opioids such as OxyContin and Percocet ARE Heroin in pill form. The molecular structure of these opiates is nearly identical and are all derived from the poppy plant. All are extremely dangerous and highly addictive forms of pain relief.

Purdue Pharmaceutical, the maker of OxyContin, knew this. But profits were just too good to share that information. (Purdue has since paid $635 million in fines after pleading guilty to false marketing charges.)

Insurance companies happily complied. Pills provide an immediate short term solution for pain, and are more cost effective than lengthier physical and holistic therapies. Insurers then began to base doctor compensation on pain management. (If you are envisioning a noose around patient necks… you are seeing correctly.)

Recently the AMA, after a judicial wrangle, reluctantly agreed to limit first time prescriptions. But the war has not been won….victory does not include leaving the troops behind.

We need immediate investment in rehabilitating our sick youth and adults.

Medicine is a big, big business, right? According to B. Lee in Forbes Magazine, “seven of the top ten profitable hospitals in the US were non-profits.” (Your eyebrows should most definitely be raised.) He quotes, “the system is broken when nonprofit hospitals are raking in such high profits. The most profitable hospitals should either lower their prices or put those profits into other services within the community.” Well why not push for a large percentage of those profits to be spent on improving addiction services?

Being a foot soldier, I have suggestions.

1. Outpatient service; often the first line of treatment, is notoriously ineffective. Heroin is classified as the most addictive drug on the planet with 1/4 becoming instantly addicted. (It also creates real physical and physiological changes to the brain.) Outpatient might be a form of acceptable treatment for marijuana abusers or sex addicts… but certainly not for heroin addicts. Why do we accept this as a permissible form of care?

2. If you are lucky enough to advocate for inpatient care, two weeks is the average stay. Two weeks only reduces tolerance and increases risk of fatal overdose. 90 days is the minimum amount of time needed for treatment to “catch.” (A full year is required for normal brain functioning to return.)

3. Removing an addict from their environs is important for success. Addiction is a brain disease. Removing quick access to destructive behaviors and people makes rehabilitative sense. There should be a demand for quid pro quo arrangements with out of state insurers to benefit those with HMOs and medicaid plans. We must find a way to do this or else only the rich or those with premium insurance plans will benefit.

4. Spiritually based programs work. Addiction is a disease that requires a form of “spiritual surrender.” That doesn’t sit well with some because it seems to imply an inherent moral failing or belief in God. Neither is true. What it fosters is recognition that self reliance is not an option when you suffer from a mental illness like addiction.

5. An increase in MAT (medication assisted therapy). Some addicts need it – and right now the number of physicians licensed to prescribe it is too low.

6. Increase the number of physicians going into adolescent psychiatric care. (One reason there are so few is because they are paid much less by insurers for their work.)

If we don’t do these things we will continue to watch our youth die.

My daughter has lost many acquaintances. Twenty-two to be exact. One male friend I recall frequently. He had a “thing” for her and had stumbled all over himself buying her shoes, groceries, and red roses. The relationship didn’t last, and he texted me, desperate, that he was “heartbroken and would never love again.”

It all seemed so overly dramatic. But he was right; he never would love again.
A week later he was dead from an overdose. He was just 22.

Stone Heart.

~ heroin heroine ~ 3 Comments

“Too Long a Sacrifice Makes a Stone of the Heart”  – William Butler Yeats

This week I had cause to worry about my child’s commitment to her sobriety. I had been led to believe that she had traveled by train to our hometown to spend time with a friend who is an active alcoholic and was, or still is, a crack cocaine abuser. This friend has a boyfriend who regularly beats her. She is a petite blonde with glassy eyes and bird like bones – but he throws her against walls and routinely blackens her blue eyes. My child was to spend the entire evening with them in a Boston hotel. She did not share this news.

Why would she choose to do these things? What good could come of this?

I felt fear – and anger.  I had a hard time sleeping that night. I took a melatonin, but it didn’t offer much relief. I also turned the phone off. I didn’t want to be woken by what I assumed would be a midnight phone call from an overcrowded emergency room. Or the police demanding I pick her up at 2 am. I imagined changing out of my warm pajamas, programming my gps, and driving into yet another cold, fraught ridden night. And then to be greeted by a kicking, screaming addict, a disgusted police officer, and the mind numbing question: how do you want to handle this?

I am still so tired and it’s been over a year.

I never got that imagined phone call. A few days later I drove up to Maine to see her myself – and she appeared healthy, happy and whole. Which made me ask myself, “why would I turn off the phone when I had a sneaking suspicion that she would get into trouble?” Why would I put limitations on coming to her aid when she had worked so hard for so long? People make mistakes. People relapse. Is it because I didn’t want to look at that fact? Or because I didn’t want to be inconvenienced?

In retrospect I should have made sure my phone was fully charged. I should have had a type written list of detoxes to call when the sun rose. And if her relapse had been fatal (as it often is after having significant clean time) I should have rushed to the emergency room to hold her.

I have a beautiful child. Despite it all she is caring, funny, hard working… and mine. Why had I allowed the past to make a stone of my heart?

Some Words Stick.

~ heroin heroine

Two quotes have been bouncing around my head recently. I read them voluntarily but didn’t invite them to stick around. The fact that they have is disconcerting. A lot of the stuff I read, or hear, vanishes pretty quickly from the old memory bank. A story twice-told can still provide a surprise ending. Sometimes, half way through a movie, I ask myself, “have I seen this before?”

But Carrie Fisher’s description of addiction has parked itself inside my drive-through brain. She writes, “It was a kind of desire to abbreviate myself. To present the Cliff Notes of the emotional me, as opposed to the twelve-column read. I used to refer to my drug use as putting the monster in the box. I wanted to be less, so I took more – it’s as simple as that.”

Unlike Carrie; when I drink I want to become more. Her explanation is so contrary to my own that it gives me pause. When I drink each sip is like a loosening of some inner bind; a freeing of my emotional gatekeeper.

Why is our response to substances so dissimilar? Carrie speaks of a daily struggle to suppress the beast. She claims her substance misuse was an attempt to quiet a constant state of emotional overload. Does the non-addict control their inner monster by subconsciously cramming it down (and employing the weekend safety valve of a couple of “harmless drinks” to avoid explosion)? If so does this mean that the addict is more conscious of emotional dis-regulation? Or are they incapable of the “cramming” part? Are they incapable because they feel more? Or because they have less free space within which to cram the over wrought monster?

Which leads me to the other quote that has taken up residence in my brain.  In The Folded Clock Heidi Julavitz confesses to carrying around a small water tap handle which she found between the studs of her newly demo-ed wall. She imagined the prior owner put it there because they didn’t want to throw it away, yet they didn’t want to keep it laying around because its daily usefulness was long gone. She contemplates what is stored between the “studs of the walls of herself…. who knows what I have hidden in there because I could make no sense of it at the time, and found nowhere else to put it.”

Which makes me wonder: what have I placed inside my interior walls? Are things taking up unnecessary space because I refuse to look at them? Or am sentimentally attached to their expired value? Should I create a little larger space inside for my inner beast to slumber or should I wake my monster and face the consequences? (Hey – is this what meditation is for? Will it both clear the mind debris and shrink my emotional beast?)

Do we have to look at all this stuff? Isn’t it annoying to have to look behind every wall? In some respects our “tap handles” are a record of a life lived. And our inner beast a barometer of our capacity to feel. The tap handle and inner beast may also represent the sum total of all of those emotional traumas we have absorbed but failed to assimilate. Funny, but when my daughter first started on her 12 step program she suggested that my husband and I pursue it as well – not because we are addicts but because it would allow a peek at our own hidden spaces.

For most of us, a certain point surely comes when the walls become overstuffed and the well over flows. Those conditions don’t just magically resolve themselves nor are they swept away by some outside force. Intimately seeing the path of a recovering addict has taught me the hard lesson that change can only come through painstaking self-analysis. Time for exploring this old house. Time to wake the monster.

Here I come 2017.

The Boy Outside of the Gym.

~ heroin heroine ~ 1 Comment

Today I saw a boy outside of my gym. He had his grey hood up and appeared to be waiting for a ride. It was 22 degrees outside. He was smoking a cigarette. Funny that; a cigarette outside of a gym. And then it occurred to me that he was in recovery. I have no proof of this random rush to judgement – just a hunch. I gave him a big smile and, contradictory to his rather unapproachable affect, he smiled back.

I felt like we had bridged, in some small way, a rather momentous divide. This may have been another rush to judgement on my part – but clearly we had plenty that separated us. Age, sex, income level and life experience for one. Most likely also politics, education, hobbies, and the content of our daydreams.

Once inside I focused on maintaining my speed on the treadmill. This is more challenging then it sounds because the desire to slow down is surprisingly strong with me – and it only takes the push of one sweaty button. Sometimes I bait myself with my daughter’s struggles… if she had the inner strength to quit drugs then you can certainly run for fifteen more minutes. (Maybe you could even, God forbid, kick up the speed.) It was then that I noticed the boy. I guess, unable to get that ride, he had returned to the warmth of the gym. He had removed his hoodie – and he was covered in tattoos. Not a tribal bracelet, soft green shamrock or the name of a lost family member. No, these were the scary kind. They traveled up his arms, his neck, his brow. They were dark and fresh and it would be hard to accept the challenge to look directly at them. I wondered if he had been a dealer. I wondered what kind of trouble he had gotten into in his brief life.

And then I saw him grab free weights – and he used them like a ballerina. Slow beautiful, deliberate arcs. Others grunted and watched themselves in the mirror. Some walked around more than they lifted. But he was lost in an interior world. At one point he looked like a Christ child; his arms impossibly spread, his posture shamelessly on display. I couldn’t help but imagine what he had suffered for his addiction. What avenues had he gone down to feed his fix? How could ones desire for something be so strong that they would risk destroying the beautiful body that they had been given?

Making yet another mad rush to judgement I decided that this is what we shared in common. A desire to both understand and to forget. And shouldn’t our interior worlds bind us more than our exterior ones?  It is unfortunate that they aren’t as obvious as race or culture.   Our interior worlds are often fiercely private and often lonely.  If only they glowed like some sort of mood ring – I am green I am working on liking myself, I am blue I am working on liking others, I am red I am working on controlling my moods, I am purple I am working on forgiving.  How cool would that be?  Then we could help each other, guide each other, or at least recognize a commonality:  I am not alone.

I have a strong feeling that me and this very different boy had lived through something regrettable and were working hard to reinvent it. A personal resurrection or rebirth of sorts. And it made sense to me, it was Christmas week after all.

I See You Mr. Double Standard.

~ heroin heroine

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.

Don’t Categorize This.

~ heroin heroine ~ 1 Comment

We categorize and sort things:
Linen closet. Junk drawer. Shoe rack.
We differentiate and label people as well:
Type A. Neurotic. Extroverted.

Classification by the human brain is typically helpful. It is meant to move us quickly and efficiently through an increasingly busy and varied world.

There probably was a day when rapid generalization of objects and people wasn’t required. Possibly we had less things to sort and each thing had intrinsic value. That spoon was a spoon. (Not a silver spoon or a plastic spoon or a baby spoon.) Possibly at some point in time we all lived in small insular villages. Each inhabitant couldn’t be categorized by a singular adjective because they were too intimately known.

Addict = Junky.

Unfortunately, this characterization exists. And, to be honest, by the time an addict’s addiction has fully consumed them there is very little left by which to define them. Jobs, families, homes, hygiene, self respect, love….. all gone. The addict becomes the equivalent of an item in the proverbial “junk drawer”…..something that used to function, but is no longer useful.

But, just like those that know the value of that random fob or tube in their small kitchen junk drawer, those of us who parent children with substance abuse disorder know their inherent worth. They are valued and loved. And worthy of repair.

-The most stand out characteristic thing I can say about my son is when he enters a room and smiles the whole room lights up.

– My son is well read, a wicked movie buff, likable, handsome, has common sense, is a great athlete, loves fishing, boarding, and biking. (He has) so many amazing qualities which makes it so difficult to understand this disease.

– My son is so smart! He was offered the Abigail Adams award for 4 years of free tuition at any MA state university or college. If only he had accepted it. He’s also so generous and thoughtful. There were so many days that he would just show up at my work with a bouquet of flowers for no reason. And he has got the greatest personality. Of my 4 adult children, he’s the only one I can carry on a full, engaging, adult conversation with.

– My son ends every conversation or exit with love you.

– My daughter has a quick trigger – but also uses it for good. She is quick to call someone out when they have hurt another. Or to notice the injustice in situations she encounters. She is a defender, with a capital D. And twice on her birthday she had friends donate money to a local animal shelter instead of giving her a gift.

– (Even) when I visit my son in jail, he can tell a funny story and make me laugh…which is a good thing!

– My son is extremely sensitive. He is a hard worker, a talented musician, and a kind person. He loves to make people laugh even at his own expense. He is so sweet with his elderly grandmother who adores him.

– My son is an extremely hard worker and his staff always would say how much they loved working for him.

– My son loves animals and is very compassionate. He is passionate about his music and loves to read. Even when he was at his worst I always felt that he loved his dad and I. He is a vegan and always concerned about what happens to animals and to our planet. He tends to take care of people he meets that he feels are struggling like him.

– My daughter has a beautiful singing voice.

– My daughter gave away her winter jacket at a detox. “She needed it more,” is what she told me.

– My son is funny, charming and charismatic. He is a fighter and so tenacious for beating the odds and overcoming so many learning disabilities, stuttering, and of course heroin addiction…at least for now.

– One day my son came bustling into the kitchen looking for something to eat. He began making pbj sandwiches and putting them into a bag with gatorade bottles and chips. A little time went by and I looked out of the picture window and saw the top of two heads.  When I looked closer, it was my son and a stranger sitting on the porch step. The stranger was eating the food!  When my son came in a little later, I asked him about it.  The man was someone my son had met days before. He was homeless and hungry. My son told him if he was in need to come round and he would help. He also sent the man off with extra food, a comb, soap, bottled water, tooth paste, Tylenol, his old sleeping bag and rain poncho. That’s my son. I have NEVER loved another human being as much as I love my beautiful son.

– My addicted daughter used to tell me when she was little that she could see into the future, I always thought that it was a strange thing for a little kid to say.

I realize it is hard for many to see the humanity in those who have lost the ability to reflect their own human potential. And most likely the world will never be a perfect place. But fully seeing the marginalized amongst us….that helps bring the village back.

 

Triggers Are Not Real.

~ heroin heroine ~ 2 Comments

“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.

Modern Love

~ heroin heroine ~ 2 Comments

There is a program on National Public Radio that does a spectacularly good job at deconstructing a word most of us feel we can confidently define: love.

In one episode Jason Alexander narrates his love for the family goldfish. The loss of someone close to him has forged his affection for this swimmingly simple little golden fish. Its presence represents an escape, and an embracing, of the crumbling reality of existence.

Can love be tempered by unpleasant realities? The program would say yes. Most of us, especially those of us with decades of life behind us, would agree.

We all have our own “modern love” story. Mine would be about my daughter, who many might describe as hard to love.  They would be wrong.

Admittedly, she was hard to snuggle.  She preferred the plastic embrace of her car seat. The car seat could be parked far from me: she was happy with any room, any corner. She tracked me with her eyes, but she tracked other things with equal interest. I took to forcibly putting her in a snuggly and walking up and down the street with her.

Glowering was also a specialty. She was a beautiful blonde baby with fat pink cheeks, green eyes, and a perma-scowl. Her mouth, right from the get-go, had a natural down turn to it. Glowering with the addition of defiantly crossed arms came later. When asked to give her name during her kindergarten interview she stood up, turned her chair backward to the teacher, crossed her arms, and sat down. She remained that way for the entire interview.

My husband and I remained enamored. (Why should she perform tricks like a trained seal? Maybe we have the next Hillary!) We affectionately nicknamed her “little black cloud.” We would mimic her mood in a dreary Eeyore voice – desperately trying to add some EB White levity to our situation. Sometimes we would just mime a “brewing storm”  by circling our fluttering hand over our weary heads.

But of course at this young age it isn’t about them loving you. It’s about you loving them.

Loving her could be exhausting. It wasn’t easy for my daughter to accept love. She appeared to weigh it, to quantify it – to find it lacking. She was often displeased. I came to see it as her natural default button. She screamed about sitting in the cart at the grocery store. She screamed at her older sister to claim the best barbie. She screamed if she could hear you chewing during dinner. She screamed for the last cookie, to hold mommy’s hand, to find the most Easter eggs. She screamed over minor transitions. It was relentless. Her ability to express love was buried under an itchy blanket of sensory issues, fear, jealousy, and an unshakeable sadness.

But she loved us too. It was apparent in the way she would fit herself to your side when watching a Disney movie. And in the occasional half smile with tilted head. In the way she kissed her dog’s bearded face. And the gifts of found flowers or crayoned pictures.

So, yeah, love is not only tempered by unpleasant realities… in can grow in them. It may even grow hardier. We are living proof.  We are the dandelions of love.

Trap Houses vs. Safe Houses

~ heroin heroine ~ 3 Comments

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.

Partying with the Sober Folk.

~ heroin heroine

This time a year ago I was my daughter’s guest at a recovery barbecue. We made our way there via a South Boston park with harbor views. People were playing what appeared to be a game of “pick up” baseball. A handful of lucky fans sat under the few trees that sported shade. I kept walking through invisible puffs of cigarette smoke. Children were screaming with their mouths entirely full of half eaten hotdogs. It was, you know, quintessential American stuff.

We found the recovery center across the street – in the scrubby back yard of a former church property. Outside an old man with a gold tooth was watering an incredible, and I mean incredible, garden. He smiled at us.

Inside the yard we were handed raffle tickets. Strangers cooked us hamburgers. We drank extremely cold sodas from an overly iced trash can. People made room for us at crowded picnic tables. We ate watermelon and chips from wicker baskets. We listened to top 40 music from speakers slung here and there.

I watched a young man perform a break dance that was skillful and unabashed. He spun with pure joy on a small patch of concrete. His eyes were half closed. My self conscious self had nothing in common with him. At the time I thought it was the dance that enthralled me.

Later this same boy shared his story. His drug use had left him homeless. He had slept under a bridge for a year: through a Boston winter. His life had been saved by another person at the party.  His life had been saved by some guy at the party.

How many of us ever save anything? Maybe we salvage a burning dinner, or retrieve a lost accounts payable receipt. Better yet, we preserve a colleague’s job. Or rescue a stray dog. Those are all great for sure… but not quite the same.

Clearly this was not your typical barbecue.

When the young man won the raffle prize (a long sleeved jersey) he handed it to my daughter. He knew she liked it. Possibly he was trying to impress her, but of that I am not certain. I do know that he most likely owned very little…and he gave it away just to see her smile.

Inside the building we found my daughter’s counselor playing the cello. She had it steadied between her legs, and her tattooed wrist held a delicate, long bow. A young man with the teeth of a meth addict accompanied her on the guitar. The sound of her cello and the sound of his voice broke my heart into a million, billion pieces.

I have been turning this day over in my head for a very long time.

“PTSD” – Post Traumatic Stress Disorder

~ heroin heroine ~ 2 Comments

This is when I am supposed to reference Webster’s dictionary. I can picture the bulleted item list that has been carefully compiled by doctors and psychiatrists, and craftily winnowed down by editors.

Yet words are bound to fail. PTSD creates a feeling that can not be contained by bullets or paragraphs. If forced to use words they would be: “sense of dread.”

A sense of dread accompanied by unwelcome imagery. Imagery that is not imaginary. Dread that is not unjustified.

The ring of the phone makes me ill. Physically ill.
A knock on the door? Visions of a police officer.
An envelope without a return address?  Bad news.
My daughter not texting for a few days? Relapse.
Sad song on the radio? Message of doom.
Bitter snow? Frostbitten child.
Cheap motels off the highway? Sadness, loneliness, death.

My list could be longer. But it hurts to write it. If I suffer from PTSD, how badly must my daughter suffer? I have seen the results of her use, but have not lived through the experience of it.

“Conquer your fears” is written everywhere nowadays – from business journals to self help magazines. But the kind of fear they often refer to is that of financial risk. (Or a lifestyle change: try that new vegan diet! get a new partner! make a career switch!) I am talking about a different kind of fear. A primal fear. The fear of losing your stormy green eyed child to something so unpredictable, so misunderstood, so maddeningly unacceptable. I have written my daughter’s obituary in my head. I have actually looked in my closet to see if I have an acceptable black dress. These were my attempts to conquer my fear. My attempts to claim and manage the unacceptable.

Nelson Mandela says that “courage is not the absence of fear, but the triumph over it.” That the “brave man is not he who does not feel afraid, but he who conquers that fear.”

I am not there yet. But my daughter is. She is putting one step in front of the other…. steady and straight. Even with those swirling thoughts that must exist in her head. If I had to provide a picture of bravery for Webster’s dictionary it would be of my stubborn green eyed child making her way across a tight rope.

And I am waiting on the other side.

Dunkin’ Donut Straws

~ heroin heroine

Dunkin’ Donut straws are thick. You need a decent pair of scissors to cut them. Cut in four inch snippets they are perfect for snorting drugs. Crush a Suboxone pill into a perfect pile of orange dust and use your color coordinated straw. The high is similar to that of heroin, but lasts longer. My daughter used to explain it this way, “I can’t overdose you idiot. It has naloxone built in. You don’t know a fu*&ing thing.”

I know this much: finding sawed off, shotgun-style straws scattered around your child’s bedroom is not a good sign. Ditto with disemboweled tampons. (The thinner interior tube makes a pretty sturdy straw).

So what is Suboxone? It is an opioid agonist prescribed by specially licensed doctors to relieve addicts of their cravings and to prevent withdrawal symptoms. It is comprised of two ingredients: Buprenorphine (“Bupe”) and Naloxone. Bupe mimics heroin by attaching to the same receptors in the brain, but doing so “imperfectly.” Its partial attachment provides the same sense of euphoria and reduction in pain. According to its manufacturer, Reckitt Benckiser, it is safer than heroin because it doesn’t fully occupy the receptors, and it has a ceiling effect, thereby decreasing the possibility of full respiratory arrest.

Unlike heroin, Suboxone has Naloxone built in. Naloxone is an opiate antagonist because it prevents opiate receptor attachment. Its presence prevents patients from misusing the pill, which is supposed to be taken orally.  The FDA warns that if injected or snorted, the Naloxone will fill the receptors faster than the Bupe – thereby negating any intention by the addict to achieve a quicker, stronger high.  An unintended result could be precipitous withdrawal – something most heroin addicts would like to avoid at all costs.

I also know this: my daughter got high as a kite from abusing Suboxone. She did not suffer from its immediate use. She suffered from her love of it. At $20 a pill, she couldn’t afford it for long. At $5 a bag, heroin is cheaper. And when you are addicted, you are addicted.

And there are a whole lot of people addicted to Suboxone.

I will also tell you what I don’t know: the answers.  I know that the medical establishment doesn’t have them yet either. Medication assistance has its place in the pantheon of drug recovery. I sat across from a young mother at a Learn2Cope meeting who explained that she wouldn’t have made it without Methadone assistance. And I have heard many parents say Suboxone saved their children. I watched a doctor tear up because Suboxone helped his patient avoid constant relapses. But I also know that it can be abused. The pills crushed, or the sublingual film cooked down and injected. I don’t know if this was considered during its trial phase. I hope it was and that there wasn’t a pharmaceutically driven rush to profit from its marketability. But I suppose, like anything, the benefits were weighed against the risks. It’s just hard to reconcile the fact that with a single prescription you are handing a known drug addict the means to better health, or the means to further destruction. I wish the process to recovery was clearer, simpler, cleaner.  Unfortunately, I know that it is not.

Comfortable with Uncertainty.

~ heroin heroine

Comfortable with Uncertainty is the title of a book by the Tibetan Buddhist monk, Pema Chodron. Pema has written many books… and they all have portentous titles such as “Start Where You Are,” “The Wisdom of No Escape” and “When Things Fall Apart.”

Pema is speaking to me.
But a Buddhist would say that there is no me; we are all one.

“It’s not all about you.”
I have heard this before. My daughter would holler this when I would try to get her to conform, behave, listen, follow.
(She said a lot of things… this being one of the milder retorts!)

But she was right.
It’s not all about me.

A yoga teacher once told me that it is the ego at work when we think we can control the outcome of any event. Even if that outcome has no selfish impetus. Even if that outcome is to solely benefit another – like recovery.

She questioned me: “If you didn’t take credit when your eldest aced the SATs, or won the lead in the play, why would you own your other child’s difficulties?” She further explained; “If you believe you are responsible for another person’s failures that too is the ego at play. You are, in essence, believing you have a Godly amount of control over another individual’s actions.”

So, where does this leave me? If I am no longer an active participant do I assume the role of spectator?   Do I alternate between cheering from the sidelines or averting my ashamed gaze?

No. As Pema reminds, “just start where you are.” Starting necessitates setting off, not standing still. Basically; get yourself back into the game.

The thing is, if you keep playing, at some point you no longer keep track of the wins and the losses. It just becomes a series of parade like hills; some up, some down. Eventually you realize others are playing the game too. We are all part of this shifting, moving, undulating life force. There are no bystanders. And there are no ultimate victors.  We are all on the same team.

“A Bitter Pill.”

~ heroin heroine

I hate idioms….cutesy tidbits of advice that fashion themselves as sage life lessons. You’ve heard them; “it’s a blessing in disguise,” “it takes two to tango” and the ever popular, “let sleeping dogs lie.”

You know what? It’s not always a blessing. And one person alone can perform quite a destructive tango. And let sleeping dogs lie? That’s just a lame excuse for not “getting your hands dirty.”

But I have to admit idioms have their place. There was a time when I relied upon them for their simplicity. Caring for an addict can turn the highest functioning brain into unstable mush. Rational thought processes become clouded by lies, self deception, and blind worry. So you adapt. Part of your mind shuts down and does not allow the conscious brain to record one more crippling incident. Another part goes into hyperdrive and busies itself with layers of extraneous nonsense; so much so that sleep can become a luxury. And then there is the imaginary brain. In order to spare whatever functioning grey matter you may have left you simply believe the lies you tell yourself. And the lies being told to you.

Of course none of these behaviors are symptomatic of good mental health. But what else can you do? Try to make sense of your daughter face down in watery ditch in a blue shiny party dress? Try to accept the presence of a hypodermic needle in the side pocket of your new black leather handbag? Believe in the sincerity of the two men who arrive in the middle of the night and roll your bloodied incoherent child onto the soft colored pea stone that comprises your driveway?

This is what you do. You chant an idiom. It becomes a very effective mantra.  Something like:

Tomorrow is a new day.
One step at a time.
Relapse is part of recovery.

Another that has helped is “detach with love.” I have to admit it is hard to detach without feeling anger or pity. Detaching with love is difficult. It feels like not caring. But if you recite it with added inflection on the word “love” – then it almost works.

My all time favorite idiom is “don’t get sucked in by the tornado.” It is very hard to not be reactive. You want to fix the issue, defend yourself, or argue a point. But you can’t win with someone who is actively using. While the world around you is starting to blow hard you calmly recite “don’t get sucked in by the tornado.” Over and over and over again. It’s a form of detaching with self love.

Pretty Rat Cage.

~ heroin heroine

There is a popular TED talk by Johann Hari that has received nearly five million views. In it he reports that after three years of extensive research he is convinced that we are incorrectly addressing addiction treatment. Instead of using punishment as a deterrent we should be saying “I love you.”

I wish I could have said I laughed. Instead my breath died in my throat. Of course I take this particular TED talk a little more personally than most. The premise that a lack of love had somehow been the missing ingredient… well, let’s just say I took umbrage.

Hari bases his conclusion partly on research done in the 1970s by Professor Alexander of Vancouver. Alexander recreated an experiment done earlier in the century that showed caged rats consistently chose heroin laced water over fresh water. In Alexander’s experiment the rat cage was outfitted like a rat “park.” They had room to exercise, ate good food, and had females to fraternize with. The result? The rats hardly ever touched the heroin water. The conclusion? Addiction is about your “cage.” (If only we had prettier more loving cages….)

I venture to say that such a conclusion is over simplified. If this were true the poor would be more likely to suffer from addiction than the rich. (This, by the way, is categorically untrue.) And, from personal experience, if loving an addict cured addiction – well then my daughter would be well. There are thousands of us who love our sick children – love them unconditionally! – and they remain addicted.

However, I do believe that self love is lacking. Parents of addicts report a higher number of children that suffer from low self esteem, personality disorder, social anxiety or depression. I have also heard parents say that these children were uncharacteristically giving…almost to a fault. And that they naturally gravitated to connecting with the “underdog.” Addicts themselves nearly unanimously acknowledge feeling uncomfortable in their “own skin.” They report feeling “different,” “misunderstood,” or “alone.” Hari cites this as failure of social engagement – a result of our bigger homes and social media interactions. But here again I beg to differ. We have always had addicts, even when we had closer knit social circles. The social disengagement is more likely an internal process, not an external one.

I have three children, only one of whom suffers from addiction. I told each one of them that they were important, beautiful, and loved by me. My middle child did not believe me. I could see it in her eyes. When she slept at night I would sneak into her room and whisper these things again into her ear. I was hoping that somehow, just somehow, my words would imprint themselves on her unconscious brain. I was singing her love songs.

Observing the Pattern.

~ heroin heroine

“I woke up twice last night. And not to go to the bathroom. My body was sweating, heart racing, my eyes impossibly open. Normal nightmare body response. Except this was not a typical nightmare. I wasn’t falling, or being chased, or recycling scary bits from a ridiculous movie. This was real. I saw Sarah running up to my car window proclaiming that she had been discharged from the hospital, and asking me to buy her some cigarettes, that “she’ll owe me one.” I was so happy to see her. And then it dawned on me that she had run. That she wasn’t going to accept any help. And I was filled with anger, and fear, and sadness and anger and fear and sadness – I was spinning, and sweating, and desperate. And she was tying a long pink lace on a fancy hightop sneaker.”

Just another dream. But it is uncanny how the subconscious pinpoints the most fearsome fact of substance abuse: that the addict appears ignorant to the danger they are courting. The family, however, sees the train wreck approaching. It’s a well worn cyclical pattern. First you note the restlessness, the mounting body tension and the explosive language. Then comes the quiet storm of evasiveness brought on by late nights, sickness and lies.

This is the worst part of living with an addict. Seeing all the signs that they apparently miss. I have heard it said that the addict is a “selfish person.” A “liar.” And “hopeless.”

Addicts definitely lie to cover their tracks for as long as possible. And they are selfish – to a degree. But it is hard to think of someone who is self destructive as truly “selfish.” Hopeless? – yes, it often does seem hopeless.

Putting all labels aside; how in God’s name can you help someone who does not think they are in trouble? Who will sweetly tie a pink shoelace while contemplating where to score their next hit?

I am convinced that the addict has to slow down long enough to recognize the internal rhythms of their own bodies and minds.  Not an easy process considering man’s natural tendency is to tread the well worn path – thoughtlessly.

Unfortunately the addicts behavior is so extreme. And the consequences of their behavior that much more obvious. What they really need is the space and time to redefine their relationship with their own patterned responses.

Insurance companies, in our experience, have offered ten days within which to make this lifestyle change.   Ten days!

There is Sadness.

~ heroin heroine

Sadness pervades my every day. I suppose it’s natural to have a dip in your “happiness meter” when your child is a heroin addict. The sadness is like a low level hum in my body. Everyday things are different now. It’s hard to listen to other parents complain about the smallest of things; like disappointment in falling grades. It’s hard to enjoy a glass of wine when you know your child should not. Even previous hobbies, in my case art, become “diversions” (whereas before they set me free). It is hard sometimes to even smile.

It is better than what came before though – which was anxiety. Anxiety based on the false belief that it was up to me to solve my daughter’s problems. Or, at the very least, to put the magic elixir in her hands. Various attempts over the years include enrolling in four different schools within four years, aptitude testing, educational consultants and weekly guidance check-ins. Then came play therapy, individual therapy, family therapy, medication, psychological testing, behavior modification charts, hospitalizations, and family contracts. Then Department of Children and Family intervention, AA meetings, police arrests, court room visits, drug testing, probation, detoxes, rehabs, transitional service facilities, residential homes and sober homes.

I would do it all again. Of course I would. But I have learned to let go of the results. I have replaced my frustration with compassion. This, however, is where the sadness has seeped in.

Sadness because there is resignation. I can not fix this.  I was told this earlier at Al Anon: “you didn’t cause it, you can’t control it, and you can’t cure it.” Now I know it to be true. The sick person must ultimately heal themselves.

Resignation and compassion…..better than anxiety and frustration.

And that’s all I can say about this today.

HL 3956 just passed. (Hallelujah … and what the hell?)

~ heroin heroine

In Massachusetts we have a legal act called a “section 35” which allows a family member, or police officer, to involuntarily commit a substance abuser to a treatment facility for up to 30 days. We are fortunate to have such a process (as it is not available in many other states).

Getting a section 35 granted is not the easiest of propositions – and it should not be. You are, in essence, denying someone their civil liberty.  One must arrive in court armed with evidence that the person you seek to commit is of “immediate danger to themselves or others.”  If successful in convincing a judge of this fact, a warrant is then issued for the addict to appear in court.  To successfully win their commitment the petitioner must then best the addict’s court appointed attorney, and convince a doctor that harm is surely imminent.

I have done this four times. I am, I suppose, a seasoned section 35’er. I am also seasoned to the flaws in the system.

Four times my child was civilly committed. But only two times did she receive any treatment. Twice there were no treatment beds available at WATC, the state supported Women’s Addiction and Treatment Center. So my daughter was handcuffed and sent to MCI Framingham. MCI Framingham is the highest level security prison for women in Massachusetts. I watched as she was dragged from the courtroom, shoeless and shackled, screaming “Mom please don’t send me there…. they will not help me! Mom please!”

Lucky for me I was able to lock her pleas into a small little compartmentalized part of my brain. A part of my brain that has been built over the years to accommodate the unpleasant lies of addiction.

However, the addict isn’t the only one who lies.

At MCI my daughter was held with women who had plotted to kill their in-laws. Women who had strangled their children. Women who had stabbed their boyfriends. Women who had committed arson. Women who had committed insurance fraud. My daughter was not guilty of a criminal offense. But she was subject to roll calls, solitary confinement and body cavity searches.

Now here’s the thing – when men are sentenced to treatment and there are no available beds, they are sent to Bridgewater Correctional Institute. Bridgewater is a minimum security prison where addiction treatment is immediately provided and is similar to that received in a hospital.

What about Framingham? Did they provide equal access to treatment services ? No, they did not. The first three days of detox are spent in a single room with up to five other women. Detoxing from heroin includes severe diarrhea, hypertension, rapid heart rate, muscle spasms so large that you are often unable to stand, anxiety, insomnia, depression, and impaired respiration that makes you feel like you are underwater. Now experience all of these things together in their most extreme form. And don’t forget you are with five other suffering women. And one toilet. And a guard who doesn’t give a shit.

This is the beginning of the MCI Framingham “treatment” plan. And also the end of it. There is no counseling. There is no medication assistance (either with detoxing or maintenance). There isn’t even an AA group to attend. Women who are civilly committed for the purposes of having their substance abuse treated are incarcerated, ignored and discharged.

So the legislature finally addressed the issue in January 2016. The scramble is now on to increase the number of acceptable treatment beds. But there shouldn’t be a scramble. The ACLU won a successful lawsuit against the state a year earlier but no discernible progress had been made.

We are told the problem is solved. But is it?

If we fix the problem should we not ask why the problem existed in the first place? Lasting change can not occur if we do not question the conditions that allowed it to flourish.

Questions that keep me confounded include the disbelief, that in 2016, we still treat men with more respect than women. Or that the prison staff themselves, year after year, found the treatment of civilly committed women acceptable.  How could a judges remand for substance abuse treatment be blatantly disregarded? Are we unable to address injustice in our culture without the sword of the law? What happened to compassion? Why is a bucket and a cement floor okay?  Why?

Broken Things Have Value.

~ heroin heroine ~ 1 Comment

I have a set of flawless china. It is Lenox and it has a silver rim like a lucky cloud.

I also have a morning coffee cup. It’s crazed from being microwaved just a little bit too much.  There is a chip that serves as a reminder to not sip on that side. When the handle breaks I will, most likely, glue it back on.

Sentimental? Not really.

I have been thinking about broken things a lot lately. How my daughter’s journey has introduced me to the fractured and hidden members of our society. I have been inside too many psychiatric hospitals, too many jails, too many police stations, too many emergency rooms and too many detox centers. I have seen too many people cry.

But now I can hold these experiences in the palm of my hand like an old coffee cup. They are no longer things that happen to other people. And I can see that they have added value to my previously flawless life.

Three years ago I noted in my journal the incongruities that were becoming our norm:

“I had to pick my daughter up from an in-patient psych ward this morning. She looked just beautiful in a black tee shirt and old jeans. Her blonde hair hung in a long braid over one shoulder. I could barely see the bruise on her cheekbone. As she gathered her things to go she insisted on saying goodbye to Carl. She knocked on his door on her tippy toes, and said, “Carl come out.” “Carl, come out and say goodbye to me.” And she waited patiently. I was expecting a young boy…. but an old man came out. Wizened, beaten down, shuffling. She gave him a big, big hug. And I just didn’t know what to do with the feeling.”

Somedays I still don’t know what to do with all the feeling.  But I know I am the better for it.

Nonsensical, part II.

~ heroin heroine

The addict isn’t the only member of the family to act completely irrational. So does the mom. Alarmed by a gut feeling that something is “just not right” the mother becomes an insanely overwrought junior detective – searching rooms, tracking cellphones, eavesdropping and spying on social media. But the truth is not easy to uncover- because the addict is a very convincing liar. (And, let’s face it, a big part of the mom wants to believe those lies.)  The disease requires the addict to hide their spiraling use. And this requires lying. A lot. In fact there is a saying in the community that “if an addict’s lips are moving…they are lying.” I never liked that saying. I still don’t. But the sad fact is that once this drug has claimed your child, they are no longer your child.

Then the really irrational behavior begins. What mother would ask their sick child to leave their home? What mother would show them the door when it was beginning to snow? What mother would watch their child walk down the driveway with a sad trash bag of clothes thrown over their shoulder? And no money in their pockets? With the realization that they may never see their child again. With the realization that their baby would seek that drug wherever, and from whomever, they could? And with the very real possibility that they might die frozen and alone?

Me, that is who.

There has to be a better way.  We have to find a better way.

This Disease is Nonsensical.

~ heroin heroine

 

Heroin addiction is a disease that appears to favor those who have a neurotransmitter imbalance. Dopamine and serotonin are monoamine neurotransmitters  which regulate mood, appetite, energy and sleep.  In layman’s terms they are responsible for an overall sense of well-being and happiness.   That’s a pretty big job.   Now imagine you are low on them.  It’s sort of like you are missing the keys to your own inner kingdom.  You can live your life, but the reason for living – the sheer joy of it! – appears to be missing.

So you discover this drug.  You do this drug.  And you feel that flood of joy.  Most of us enjoy some form of a narcotic here and there – be it a glass of wine, a cigarette, a joint.   Suddenly you feel….. relaxed.  And life shines a little brighter.  But the addict is different.  The addict realizes that this is what they are missing.  It doesn’t make things shinier…. it just makes the previously dull things shine.

So the addict seeks the drug.  Addiction makes sense at this point.

But soon the drug that seemed like a savior actually shuts down whatever limited production of neurotransmitters your brain originally made.  The drug floods the addicts brain at higher levels and at a higher strength (2-4x that of the natural neurochemical).  So the brain refuses to naturally produce it.  (Why bake cookies when gourmet ones are being delivered to your door?)   And here’s the kicker – heroin also compromises all those other “feel good pathways” that have been built into the human brain for specie survival – like the desire for food, sex and sheltering warmth.   The addict’s genetic defect now creates very real biological, and neurological, damage.

The “drug of joy” will eventually leave you hungry, homeless and without the love of family and friends.  Then, the drugs beloved effect will leave you.  Addicts are always unsuccessfully chasing that original “high.”  In the end they use just to keep the sickness at bay.

Doesn’t make so much sense anymore.