Tim Lineweaver has been there and works on the frontlines. The heroin epidemic isn’t going away and it’s in your homes and your backyards.
—
*Editors Note: Names have been changed to protect the identity of those involved.
Their faces float into my minds eye like ghosts, in the way people who’ve touched us do. A hint of a smile, how they gestured with their hands or how they slouched on the couch in my office.
I hear the timbre of their voices, recall the things they confessed to and trusted me with: the unspeakable trauma, often the unseen engine that drives addiction. The violence they suffered or the groaning weight of shame they hefted all their lives from being sexually perpetrated as children. A handful of addicts, men and women, in some cases boys and girls really. Now dead from their addictions: overdosed.
As their therapist, I try not to dwell on the loss and what I could have done differently or better, because there are new cases each week and these need my energy, focus and confidence, lest I lose them too.
But, I am only human so the question nags at me. Could I have tried a new technique or prodded them in some particular way that would have gotten them off the addicted hamster-wheel and into recovery?
Her mother first brought her in out of fear that her brother’s death (also to an OD) was depressing her. I imagine Mom’s burden: not one crushing loss but two.
|
I remember “Sean” a tall, wispy-thin character who moved with catlike agility into my office, suggesting the ex-athlete he was. He would unfurl himself onto the couch and unspool his mind unbidden. I learned of his trauma, which was myriad and would make your head spin. The biggest thing for him was the death of his sister, mowed down by a drunk driver. Sean was clean and sober at the time but relapsed soon after. He dropped out treatment. I learned of his death in the obits: “died suddenly at home.” Code in these parts for two things. Suicide or death to opioid overdose.
There was also “Sharon” a sweet, serious, moon-faced kid of seventeen when I first saw her. She could have been my daughter or yours. She was at her core a quiet, considerate and deliberate kid. Her mother first brought her in out of fear that her brother’s death (also to an OD) was depressing her. I imagine Mom’s burden: not one crushing loss but two.
I know the drill because I’m in recovery too. I feel the razor thin line separating relapse from recovery and how the looming desire to use can trump all reason and even the first hand knowledge that picking up again would be self, and other destructive. A big fat fuck it all that remains a distinct possibility. The memory of the sweet euphoric warmth enveloping my body into a peaceful gauze where emotional pain is obliterated, even if only for a while though not experienced for thirty-one years could still overwhelm my best reasoning.
The larger question is why does America have such an insatiable addictive appetite, and what can we do about it?
|
So, I do whatever I have to do to stay on the bright, and I stay away from judging my clients. I have felt and still feel the stigma of being an addict too. The false and self-convenient notion that there is a superior “us” to the addicted “them” is tiresome and vexing to me. It also prevents people from recovering as shame causes retreat into self and reinforces the notion that some people have no value so why reach out?
I listened recently to a strident radio talk host the who suggested with a mixture of certainty and disgust that we take all the addicts and put them in the desert and give them a hybrid jail-treatment program. If we get rid of “them,” “we” will be better off. I have seen the addict and “he” is “we,”: the teacher, the lawyer, the cop.
How did we get into this mess, a mess that is no longer regional but has become national? It’s tempting to point at a particular angle to cherry pick the origin to suit your particular political or topical angle. It’s also tempting and understandable to focus on the opiate epidemic but alcohol is the more prevalent and destructive drug by a wide margin.
The larger question is why does America have such an insatiable addictive appetite, and what can we do about it?
The patient who has means can purchase more and better treatment.
|
It’s important to know there is no panacea or silver bullet to the problem of addictions because it is a complex, multi-variant problem. Our efforts so far, on a cost-benefit basis, have yielded very limited results. Just look at the money spent on the misguided “War on Drugs.” Billions spent, jails filled and the problem worse.
Our treatment “system” is really a patchwork of different places serving different clienteles with different needs and from different socio-economic backgrounds. Because there is no single point of entry and because most systems are scarcely resourced, figuring out where to go for help is daunting.
Most unfortunately, like our justice system when treating addictions, money talks. The patient who has means can purchase more and better treatment. This “boutique care” includes cushier facilities, excellent staff to patient ratios and much longer treatment stays.
People from poverty who are uninsured or have state insurance products, can probably count on bed shortages at detox facilities, and when access is finally gained a short stay of a few days to achieve “medical detox” as stipulated by “managed care.”
How do we stem the tide of an American cultural belief that answers to our problems lie in a pill, a bottle or some powder?
|
These clients are discharged back into the very environments the are struggling to get out of and lacking the recovery skills that a longer treatment stay would afford them. This creates a revolving door of treatment and relapse that erodes the patient’s belief that she can get clean. Odds increase that overdose will happen and people die.
There is a lot of discussion and debate here and across the country about what is to be done to solve this costly problem. Because money is allocated in disproportionate ways, different systems battle over their pieces of the pie. Maybe the pie needs to be bigger? Less interdiction and more treatment. Prevention efforts increased yes, treatment stays lengthened to give people a fighting chance, absolutely, lets put pressure on managed care to make an honest effort to let sufferers get better. Case managers to help people access good aftercare program and better coordination of services so people looking for care can actually find it.
Beyond all these things though is a larger question with a smaller solution that costs nothing. How do we stem the tide of an American cultural belief that answers to our problems lie in a pill, a bottle or some powder?
This revolution really must begin at home. Home is the place where we can model a comprehensive paradigm of health for ourselves and our children. Health: something worked at and taken responsibility for, on a day in day out basis. It is not handed to us, or consumed. Good diet, regular exercise and the knowledge that problems are faced and solved through elbow grease and perseverance. If we can prevail on ourselves to understand this, things can improve, slowly perhaps, but substantially.
A healthier American future depends on it.
Photo Credit: Jordi Bernabeu Farrús/flickr
G: It ticks me off too! Time for a new paradigm for how we work on the addiction problem!
I know Toby from Penikese and I have a research paper I have to do and I can choose anything and my degree is in treatment but I was going to chose minimum mandos and how they failed us but maybe you could give me a better one and maybe I can use your piece as a reference?
Dear Mr. Lineaweaver:
What ticks me off is how the tobacco companies manipulated the nicotine content in their cigarettes and cigars in order to get their customers addicted even faster to their products, and the CEOs never got punished for it considering the huge economic and medical costs that they have brought to the America public. Alcohol addiction to this day has cost more American lives than all the illegal drugs combine and yet, we still think that it is necessary to have it a political, religious, and social events in order to have a good time.
G: I agree that this isn’t really a new issue. Also, the issue of addiction is more serious than a particular substance. Having said that here on Cape Cod where I live, a lot of (mostly young) people are dying due to overdose. Not a pretty scene! Thanks for reading and commenting!
It is not the first time that the USA has had a heroin epidemic. We had one in the 1950s by the American Mafia unless the drug prison sentencing laws were changed and the mob leaders’ lawyers did not know about it until they and their clients came before a judge. The next one was in the 60s and 70s thanks to the CIA importing the stuff through their private airline in order to pay for their private war in Laos during the Vietnam War and our politicians did not punish for it. We also need to legalize heroin. It… Read more »