substance use disorder

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.

Sure I’ll Join Your Cult

~ heroin heroine ~ 1 Comment

Sure I’ll Join Your Cult.

This sentence makes me laugh.
And not uncomfortably so – but in a full throttle, sign-me-up kind of way.

Sure I’ll Join Your Cult is the title of a book by comedian Maria Bamford about her mental illness. The fact that the subject matter is far from funny doesn’t change my reaction. It still makes me laugh. Every time.

It implores me to poke fun of the madness in my own life:

  • Rehabs are nothing more than lock-down spas. #insurancespa
  • Fentanyl gives you more bang for your buck! #smartaccounting
  • Addiction is not for quitters. #winning

It’s sort of funny, right? I am getting a jolly little lift from this creative exercise.
I realize that poking fun at vulnerable people is pretty evil. Rehabs are not spas (beyond the gift of time to focus on health); Fentanyl is not cost effective if it costs lives, and addiction is the one thing we hope our addicts can quit.

But I just want to laugh without reservation. My mind has been too long saturated in this sobering subject matter. Even when having a good time I can hear that little jacka$$ in my brain saying “hey super glad you are having a good time right now – good for you! Enjoy yourself and I’ll check in tomorrow.”

De-coupling from reality might work. Poking fun at myself might work:

  • No I am not your mother. #freedom
  • First ever volunteer for capital punishment! #sweetrelease
  • Unicorns are welcome to give birth in my brain. #hellomadness

I could do a deep dive here on the power of laughter (but we all know the benefits) or the fact that the best jokes are based on uncomfortable realities (my son calls them “cringe jokes”).

But at this point I don’t really care to dissect it. Stay tuned: maybe I will get canceled like David Chapelle! Or, maybe I will make it super easy on myself and completely check out: I’ll just join a cult. 🙂

Surrender

~ heroin heroine

Twelve years. It’s taken me twelve long years to move the word “surrender” from the abstract idea column to the action column. Surrender has become an action, rather than the absence of action. It has moved columns because I have learned it is, by far, the hardest thing to do.

I have had some success with raising the white flag. I no longer have any preconceived notion of catching a thrown ball or successfully geolocating my way home from, basically, anywhere. But surrendering to the fact that I can not stop my own child from illegal drug use – that is heart-smashingly difficult. But reality keeps reminding me. I can not stop her from calling her drug dealer when she is overly anxious. I can not stop her from spending all of her savings, and neglecting car payments, rent, insurance and credit card bills – leaving her penniless (and sometimes homeless) time and time again. I can’t stop her from choosing to smoke crack because her sublocade shot prevents an opiate high. I can’t stop her from laying in bed for days on end after buying designer benzodiazepines from dark web shopping malls. I can not stop her from slowly – or quickly – killing herself. I want to stop her. There is nothing more that I want to stop.

Surrendering is not a new concept in the world of addiction. It’s literally step one of the Big Book. To move forward an addict must admit they are “powerless over drugs and alcohol.” This sort of surrendering is not just word play. It requires deeply accepting the insanity of their situation: admitting years wasted trying to manage, control, deny or ignore the disease. It’s the hardest, most essential, step.

Well it appears that us loved ones have to do it too. Not just pretend to do it. Or half-heartedly do it. I have to admit I can not will her to sobriety. I can not find the perfect rehab. Or a psychiatrist with a magic wand. I can not make her use her “recovery tool box.” I am helpless. Twelve long years have taught me this. Step one of the Al-Anon Big Book requires “admitting we are powerless.” Powerless meaning letting go of any misconception of control. And then actually stopping the manic, obsessive searching for the Holy Grail. So many of us admit we can’t solve it, but then spend endless hours actively trying to solve it! The stakes are so high: it’s hard to stop oneself. But after a certain amount of time we must. And, most worrisome, we must stop any future projection of everlasting wellness for our loved one. We must accept what is. It is not up to us – no matter how much we want it, work on it or wish for it.

We must surrender.
Not “sort of” surrender.

Here’s the difference though: They must let go to live.
We must let go of wanting them to live.

And that’s a very big difference.

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