April Showers Bring May Flowers

Posted on April 5, 2012. Filed under: addiction, Intervention, Parent of an Addict, Recovery, The Bottom | Tags: , , , , , , , , , , |

My daughter’s birthday is today.  She is 33 years old.  She’s living in southern California and working at a small, private women’s drug/alcohol treatment center. She has a wonderful ‘boyfriend’, a darling dog, and recently moved in to an apartment of her own.  She’s healthy and happy and a consistent source of love and support to me.  I just sent her five large boxes of household items that I had been storing – things I had salvaged from the nightmare of her apartment from which she had been evicted almost three years ago.

Soon, on May 9th, Hayley, will celebrate two years of sobriety.

 This time of year prompts such a jumble of conflicting emotions for me.  The trees and plants are budding with new life – so full of hope and promise.  Spring is here as manifested by Mother Nature’s relentless cycle of new beginnings. With a symphony of birds chirping, the greening of lawns and surrounding hills, trees leafing out, buds and blossoms everywhere, it’s hard not to feel renewed and optimistic – even buoyant. 

However, three years ago, all that changed – and this particular time of year took on a very different mood –  a different kind of feeling – a sort of pallor.  Despite the loveliness and allure of the season, it will forever be tempered by the grim reminder of what could have been.

In 2009, when my daughter turned 30, I threw her a birthday party in a desperate attempt to cheer her up and show her how much we, her family, loved her.  There were mostly family members and a few close friends  who had gathered for the weekend. Hayley had been unemployed for almost nine months – and seemed increasingly depressed, remote, and ‘unavailable’, punctuated with episodes of erratic/bizarre behavior.  On the Saturday afternoon before her birthday dinner, we had planned a family hike.  Hayley ‘begged off’, claiming she had some important errands to run.  Huh?  We had all come together, many from out of town/state, to be with her on this milestone birthday.   However, over the years, we had become so accustomed to Hayley’s ‘flakiness’ and narcissism, that we shrugged off her ‘lame’ excuse, determined to spend quality time together on the hike, in spite of her absence.

The birthday dinner went well – it was so wonderful to have everyone together – including my 91 year old mother. The next morning, however, Hayley didn’t show up for the family brunch we had planned.  She finally arrived ~ 1:00 pm – late, disheveled and spacey. I was very upset and suspicious – but focused my attention on smoothing things over for my elderly mother’s benefit, who is a professional worry-wort.

Many months later, I learned that Hayley had spent Saturday afternoon at a dentist’s office, getting prescription painkillers.  And after the family birthday dinner, she had used a variety of drugs, crashed/overslept at a friend’s apartment, and couldn’t remember where her car was the next morning.

Two years ago at this exact same time, amidst the riot and rejuvenation of spring, I was almost paralyzed with despair, fear, and overwhelming gloom.

My daughter was now an active heroin addict, living a very abusive, risky, dangerous lifestyle in a crack house.  Her likely life outcomes had boiled down to a few grim options: untimely death by overdose, violence, infection or, going to jail.

Here’s an excerpt from a post during that time to give you some context:

I’m getting ready to meet with my daughter for the first time in seven months.  In June 2009, I had learned that Hayley had become a heroin/crack cocaine addict and was living in a crack house.  A couple of months later (August 2009), she had reached out and asked for help – specifically, would I get her in to a medical detox facility?  She had managed to get herself out of the crack house and had found a safe place to stay for a few days.   She was dope sick, covered with abscesses, and desperate for help.  Of course, I donned my ‘supermom cape’, and whirled in to action. 

The logistics of quickly getting Hayley in to a medical detox facility were complicated, since there was no such facility here, in our small-ish city, and no available beds in the detox facilities 150 miles away.  We needed to first get her on antibiotics to treat the abscesses, before any facility would take her (MRSA risk). And, I procured some hydrocodone for her, to try to keep her off the heroin and away from the crack house. After 72 hours of constant phone calls and involved paperwork, and buying food and clothes for my daughter, and checking in on her, and trying to keep her hopeful and moving forward, and not using heroin (this was my fantasy, as it turned out), a bed finally became available at midnight, and I drove Hayley three hours to the detox facility.  The plan was, after detoxing for ~ 5 days, Hayley would go directly to a women’s treatment center 50 miles away.  However, after 4 days in detox, Hayley walked out AMA (against medical advice) and talked a taxi drive in to driving her the 150 miles back to our town – and her drug life.  One of the many ironies in this chain of events, was that the crack house wouldn’t take her back!  Can you imagine? This is a whole story, in and of itself. 

 We decided as a family, at that point, to pull back and let Hayley really hit “bottom” –  to let her feel the full impact of her life choices, hoping that this approach would jolt her in to seeking recovery on her own.  She’s smart.  She’s resourceful, and I truly believed that she knew where to go to get help for herself.

 And so, for the next 7 – 8 months, we had little to no contact with her – just an occasional text, since the failed treatment attempt.  During that time, I was desperate with fear and worry, and felt overwhelmed with helplessness. However, after about 5 months of not speaking to or seeing her, I had reached some kind of “tipping point”, and decided to try to contact her. It all started with a text, then a phone call, and then a few more, culminating in my determination to actually see my daughter on her birthday in April.  We had re-established enough of a connection to build the foundation of trust and desire necessary for our eventual birthday meeting.  I was convinced that Hayley’s life was at stake and time was running out –  that I needed to make one last valiant attempt to help her get the help she needed to change her life.  If I could appeal to her and tell her, face to face, how much I loved her – – – and that we, her family, would help her get the help she needed when she was ready, maybe it would make a difference. I had to try.

 My reaching out to Hayley was influenced, in part, by Tom, a drug counselor at the  Recovery Helpdesk blog, who made a good case for challenging the notion of  Hitting Bottom– that . . . 

” . . . an opiate dependent person does not have full exercise of their free will.  Their free will is compromised.” And, ” Opiate dependence is powerful enough and the opiate dependent person’s free will is compromised enough, that waiting for the person to “hit bottom” can mean the person goes on to experience HIV infection, Hepatitis C infection, unemployment, homelessness, incarceration, loss of child custody, loss of family relationships, risk of violence, or worse.”

It was uncomfortable to read this, because it challenged our family’s position that Hayley needed to feel enough pain before seeking help, which was what most professionals/groups/literature advocated.  Leaving Hayley alone for 7 months hadn’t really had the effect we had hoped for – she just seemed to spiral further down in to the deep dark hole of addiction and become more entrenched in her risky lifestyle.  And from what I could tell, she was getting more desperate – dope sick almost every day, no money for drugs, let alone food.  I was driving myself crazy contemplating how my daughter might be getting her drugs.

My post, Birthday Gifts, gives you the details of my preparation for this crucial meeting with my heroin addict daughter on her birthday, two years ago.  And Yes . . . She’s Still in There is the account of the actual meeting.

Thinking back to that time is still very painful – and a frightening reminder of how close we came to losing our daughter completely.  But, it also is a powerful testament to hope – and miracles –  and how the most desperate circumstances can change.

There are so many variables that affect an addict’s recovery – timing being one of them. Apparently, for Hayley, the combination of our birthday meeting, followed by a crucial/random phone call from an acquaintance, subsequent phone calls and texts from family members, and other serendipity events –  all came together in to a powerful vortex that started to draw her in – and remind her of the ‘normal’ world and life she had left;  that there was a possibility of a different kind of existence; and maybe she could accept help.  Who knew, or could predict, that these somewhat arbitrary events could converge in to the powerful push my daughter needed to walk away from her life of addiction.

A phrase of drug counselor Tom’s, at Recovery Deskhelp, kept running through my head: that taking action to enable recovery is very different from enabling the addict’s drug use.  I was convinced that my daughter was incapable of getting the help she wanted or needed – that navigating the complicated labyrinth of getting herself into a detox/treatment center, was too overwhelming – and I was right.  I am grateful to Tom for articulating what I felt in my gut – and for his strong voice in advocating harm reduction and a wide range of recovery options for drug addicts.

Tom’s post at Recoverydesk, Tough Love Delays Recovery For Heroin Addicts,  is especially relevant to this discussion and his view that “enabling” and “tough love” are the two “black and white” extremes – both of which can be harmful to the drug addict’s recovery.  There’s a lot of gray area in between that is sensible and reasonable and should be considered.    http://www.recoveryhelpdesk.com/

I ended my post, Open For Business, a little over two years ago, with this:

Hayley’s birthday is a little over a week away.  She’ll be 31 years old.  What do I get her for her birthday?  What does one buy, wrap up, and deliver to their heroin-addicted child?  I know, I know – love, encouragement, hope – – – and recovery, are what she needs most.  At this point, I just don’t know how to give and get those gifts to her.

I guess my point in recounting all of this is, to never give up – that as long as ‘your’ drug addict is still alive, there is hope for recovery.  My daughter is living proof of this miracle.  And today – this year – this April 6th, I am reveling in the hope, promise, and wonder of spring . . . and recovery.


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Yes . . . She’s Still In There

Posted on April 7, 2010. Filed under: addiction, Parent of an Addict | Tags: , , , , , , , |

First of all, I want to thank all of you for your sweet words of support, empathy, and encouragement.  Each of your comments was helpful and carefully considered.  Even though many responses were coming from completely opposite perspectives, they all made sense and were comforting. They gave me the strength to do what I wanted and needed to do.  I am eternally grateful for your loyalty and concern.

Today, on Hayley’s 31st birthday, we were supposed to meet at 4:00 pm, across the street from the crack house where she is living. I was very nervous.  I hadn’t seen her since last August, and I was afraid to see what she looked like after using heroin for nine months.  And in addition to these inherent fears, a good family friend, Lilly, called me last night to report that an acquaintance of hers, Dan, had some news of Hayley. Dan lived across the street from the crack house and had recognized Hayley there and her comings and goings.  He called our mutual friend, Lilly, to ask if I knew that Hayley was living at the crack house – and to report that Hayley had been over to his house a few times.  The most recent visit she made was just a couple of days ago.  She did not look good – was dope sick, and had asked Dan if he had any money or drugs he could give her.  When he said no, she asked to borrow his phone to call her drug dealer.  I was confused by this information – I thought Hayley’s drug dealer, Bill, lived with her at the crack house.  As you may recall, Bill and 2 of the other crack house residents, were arrested in a drug bust/house raid by federal agents, about 3 weeks ago.  “I hate calling you, dear friend”, said Lilly.  But I wanted you to know. Hayley is not in very good shape – and doesn’t look good.”  This “Hayley-sighting” sounded so pitiful and desperate, I was shaken, yet grateful for the “heads up”.

So – this was the information I carried around with me all day, fueling my fears and anxieties as I tried to prepare myself to see my daughter. Seeing Hayley was going to be as bad, or even worse, than I had imagined.

I was determined today, however, to focus on who my daughter truly is, deep inside – the beautiful, talented, intelligent young woman she was and hopefully still is, not the heroin addict.

I had put together a bag of birthday gifts for Hayley: new underwear, some glacier blue sweat pants and hoody, t-shirt and turquoise fleece (Costco), toothpaste, toothbrush, soap, shampoo, tampons, 2 CDs of songs that I had selected and burned for her (SongsForMyDaughter), new mascara, lip gloss, blush, lotion, etc.  I also bought some groceries – 2 bags of fresh fruits and her favorite foods.

And then, all day, the lurking question of:  “Do I give Hayley her money that she had asked for?”  There were good arguments on both sides of this question.  My therapist, and a majority of blog viewers advised that I not give her the cash. (see the previous posts’ comments) Again, I so appreciated all your input.  Recovering addicts’ words and opinions were especially helpful.  I ultimately forged a compromise and decided to give Hayley ½ of her money: $130, and will use the other ½ to pay on her most recent ER bill. I fully acknowledge the fact that this money, Hayley’s money, would buy me some time with her.  Most likely just another 5 minutes or so – but worth it to me. And, I didn’t want to get in to a reactive exchange with her regarding the perception of my trying to control her access to her money.

The tension-filled countdown to my daughter’s and my meeting began around 1:00 pm.  I was so ambivalent about seeing her.  I desperately wanted to, but was also deathly afraid to.  I had a busy schedule today, and didn’t arrive back home until around 2:00 pm. I got the birthday gifts and food bags together, the birthday card written with carefully chosen, yet heartfelt words, printed out my last blog post for her about who she was, and hopefully still is deep inside, and loaded everything in to the car.

And then, at 3:30 pm, the phone call came. Not a text, but my daughter’s actual voice on the other end. It was from a phone # I didn’t recognize.  “Hi, Mom.  Can we meet a little later?”  This is her usual pattern and something I’ve come to anticipate. I was certain that this would escalate in to more meeting time delays and eventual cancellation of our get-together.  “Sure,” I said.  “Just call me when you’re ready”.  I intentionally tried to sound nonchalant versus annoyed.  The next phone call, from the crack house, was  at ~4:30 pm:  “How about 5:00 pm?”, she said.  And, “Mom – can you do me a big favor and bring cigarettes?”

For an instant, I hardened and felt manipulated – and used.  However, I dug way down and tried to focus exclusively on my goal – to see my daughter and make some kind of meaningful connection with her.  And so, I got into the car, and headed to the grocery store to buy cigarettes.

This is getting long – I’m sorry.  But the upshot of it all is – that I picked up my daughter at the crack house and we went to a nearby park to talk.  It was if we had never been apart – in time, and space, and worlds. We talked, and laughed, and cried.  My carefully thought out script evaporated, and I was able to ask her important questions and tell her things I wanted her to know. I couldn’t believe how effortless, genuine, and intimate it was.  Hayley willingly offered information and details of her life that were both revealing and touching. She made fun of herself and her absurd life, world, and circumstances. She told me that she was still receiving unemployment checks – and they would continue for another nine months – and that this money was used for group living expenses and, of course, her drugs.  She said that five people lived in the crack house, including herself, and they were, essentially, like a family.  They all shared what they received/had, and checked on one another.  No one was allowed to stay in bed all day – that no matter how you felt, you had to get up and do your chores and contribute in some way to the “well-being” of the group.  Hayley even wryly added that she had learned some things – like, you make yourself get up and do what you need to do. This news was surreal-ly hopeful to me.  I told Hayley about my blog and one of my posts about how hard it must be to be a heroin addict – and that if you can successfully navigate in the drug world and  be a heroin addict, live the lifestyle and stay alive, you’re capable of doing anything.  We laughed and cried at that revelation.

I was taken aback by Hayley’s appearance.  She was very thin and her hair was dark brown.  She’s always been “blondish” before – due to regular highlighting sessions.  I told her that she looked old.  “Really”?, she said.  “I’m not surprised”, she added.  She looked at least 40 years old.  She was pale, and her face very angular.  Her teeth were yellow, but at least none had been knocked out like I had imagined. And, I noticed some gray hairs in her head. When I mentioned that, she was shocked.  Her hands were reflective of her lifestyle:  dirty fingernails, torn, bleeding cuticles.  And when I hugged her, her shoulder blades felt so sharp – with hardly any flesh or fat on them.

I felt better about giving Hayley her money after learning that she was still receiving unemployment.  I dunno – – – this news about her unemployment money meant, to me, that maybe she hadn’t had to prostitute  herself to buy drugs.  And even though I’m embarrassed and ashamed by the fact that my daughter is a parasite on society and using our tax dollars to feed her drug habit, I’m also relieved.  She’s getting government money to live on and buy her drugs which means that possibly, she hasn’t had to totally compromise her core moral/ethical values as a person.  Odd dichotomy, isn’t it?  I let myself believe that the $130 I gave her would be used for food and “rent”.

Hayley smoked a cigarette that she “desperately” needed while we were together.  I made an analogy between breastfeeding an infant and using heroin – – – that both require careful planning and scheduling. She agreed, and we both laughed.  During our visit, the absurdity of her life just seemed to strike both of our funny bones.  Was this a manifestation of stress?  I don’t think so. For me, it was acceptance, reality, and intimacy with my daughter. When Hayley plowed through her gift bag and discovered the make-up, she immediately applied mascara, eye shadow, and blush, casually commenting that she didn’t spend too much time on her appearance these days.  This seemed so crazy and funny to me, I just burst out in to giggling, infectious laughter.  Both of us did.

I had been in contact with my youngest son, Brian, all day.  (see Cast of Characters tab) He is such comfort and support to me – and is the embodiment of love and light.  He tried to send me a text with a video of his birthday wishes and greetings to Hayley, but it didn’t come through on my cell phone.  So, while Hayley and I were together today, I called Brian, and he was able to directly speak to her.  It was a beautiful, touching few minutes of exchange between baby brother and big sister.

A few miscellaneous tidbits:

•Hayley said that when the federal agents/SWAT team surrounded and raided the crack house a couple of weeks ago, they were not very thorough in their search.  They didn’t find any drugs – just 2 scales, that are considered “drug paraphernalia”.

•Bill, the crack house owner and head honcho, was bailed out of jail by his parents.  He faces some charges, not sure what.

•Hayley said she was ‘gonna’ apply for food stamps and the Dept of Social and Health Services (DSHS) DATSA program, which could ultimately  pay for drug rehab.  She’s been reluctant to register with DSHS, the state welfare system, for fear of being arrested (there’s a warrant out for her arrest for violating probation).  The fact that she was even thinking about going to DSHS was encouraging to me.

I don’t know if the stars and planets were in alignment today – – – or if god, jesus, buddha, mohammed all converged to hold my hand.  Whatever it was, I am grateful for the opportunity to see my darling baby girl on her birthday. My meeting with Hayley today, broke the ice of our 7 month separation. I was able to tell her how much I loved her and connect with her in a meaningful way.  I know that she is OK – – – and most importantly, I saw real evidence of the Hayley I once knew.

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Birthday Gifts

Posted on April 5, 2010. Filed under: addiction, Addiction Resources/Support, Parent of an Addict | Tags: , , , , , , , , |

I received this text from my daughter at 1:00 am on Easter Sunday morning, from an unfamiliar phone #:

Hey mom, it’s Hayley. Hope u are ok. Was hoping to get my **** stock money.  Could really use for food, bills and bday. U still have?  Please let me know.  Love u.  H

Hmmm – and there you have it – it all eventually boils down to money, doesn’t it?  My desperate heroin addict daughter makes contact after not hearing from her for weeks, to ask for money.  Granted, it is legally her money.  However, I now have Power of Attorney (POA) for her, and feel entitled to apply my discretion in her financial affairs.

I’m grateful she’s alive.  I learned a few days ago that she was in the ER on March 5th.  I received a bill from the hospital addressed to her, at my home address.  She owes $350 to one of our two community hospitals for this most recent ER visit (her last ER visit in July was to the other hospital).  From a quick assessment of the hospital statement, I’m assuming she went to the ER for injection site abscesses.  I can’t help but think about how long she must have  waited and how bad it must have been, before she finally got herself to the ER. Her father was a very successful radiologist and practicing physician in this small city for almost 35 years.  Her surname is unique enough, that any ER doc/staff would recognize the name and know who she is.  I shudder at what it must have taken for Hayley to overcome the name recognition, shame and humiliation to finally go to the ER.

My newly acquired consciousness regarding the inhumane treatment of drug addicts in hospital and emergency room settings, is heightened.  I refer you to this post, Puss-y Stuff for details and a new perspective on compassion for and more humane treatment of drug addicts.

I was raised in a very religious family, went to church every Sunday, and sang in the youth choir for the first 17 years of my life. I eventually married a Jewish man and ultimately acquired a more diverse world view and perspective on “god” and different spirituality practices.  For this, I am eternally grateful.

Today, I attended the First Presbyterian Church Easter service with my 92 year old mother, my brother and sister-in-law.  And even though I couldn’t bring myself to take Communion and pledge myself to Jesus Christ as my “Saviour”, I sang all the familiar hymns and doxologies with sincerity and gratitude.

Here are some phrases and song lyrics that resonated: From this day forward . . . and,  . . . all that I’ve done before won’t matter anymore . . .

At this service, I filled out a prayer card to ask for my daughter’s desire . . . and courage and strength, to change her life.

And in that spirit of hope on this Easter Day – and with my daughter’s 31st birthday approaching, I’ve found peace in the decision to make an extraordinary effort to meet with her on Tuesday, her birthday.  I will deliver a bag of small, modest gifts:  2 packages of new underpants, tampons and panty liners, an aqua hooded sweatshirt and pants and fleece (from Costco), fresh fruits and veggies – – – – and, $130 in cash – which is ½ of her annual stock dividends.  I know this money will be going directly up her veins.  That’s ok.  The other ½ of the stock dividend money I will be delivering to our community hospital as partial payment of her most recent ER bill. And, I will ask to speak to a social worker and have Hayley’s chart flagged, in hope that the next time Hayley visits the ER, a social worker will be called to speak to her and offer her some options for treatment and recovery.

My message to Hayley on her birthday will be one of love – – – and to offer the possibility of “Harm Reduction” versus detox and a “cold turkey” rehab treatment center.  Thanks to Tom at RecoveryHelpDesk, my perspective on realistic approaches to moving opiate addicts away from their risk of acquiring Hepatitis C, HIV, a variety of infections, pregnancy, physical/sexual abuse, and criminal acts, takes precedence over getting them in to some 12 step program that won’t allow diversion alternatives such as suboxone and methadone.  I’m hoping that Hayley will consider this option, and feel she could maybe take this step.  Personally, I feel that Hayley wants to stop the addiction cycle, but doesn’t want to or cannot do the work required to completely abstain from all substances.  Perhaps she needs a transition – a phased move in to recovery.  Wouldn’t suboxone be better than using heroin?

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Staying Alive

Posted on March 15, 2010. Filed under: addiction, Addiction Resources/Support, Treatment Centers | Tags: , , , , , , |

A few days ago, my friend, Ang, texted me to tune in to National Public Radio (NPR) and listen to an interview that they were doing with Dr. Gabor Maté.  I wasn’t near a radio and couldn’t listen to the program, but later, I did google Dr. Maté.  Here’s some interesting info regarding Dr. Mate’s controversial work in Vancouver, BC.

Dr. Gabor  Maté is a physician specializing in the treatment of drug addiction in Vancouver, BC. For over seven years Gabor Maté has been the staff physician at the Portland Hotel, a residence and harm reduction facility in Vancouver’s Downtown Eastside. His patients are challenged by life-threatening drug addictions, mental illness, Hepatitis C or HIV and, in many cases, all four.

Tune in to an overview of this drug addiction treatment center on CBC’s TV series, Staying Alive and read what’s been written about it below:

“It has been called “an abomination” by a minister of Stephen Harper’s Canadian government. Its staff members claim it “saves lives.” A regular client calls it “a community centre for junkies.” Whatever you might call it, Insite is the only one of its kind in North America — a supervised injection site for drug addicts.

Insite, located in Vancouver’s notorious downtown eastside, has been controversial since it first opened its doors in 2003. An exemption from federal drug laws was granted to allow addicts to bring their drugs onto the premises and inject them; Insite provides clean needles and medical supervision. It’s funded by British Columbia’s government and championed by community leaders, but Harper’s government is openly hostile to it and is trying to shut it down.

Now, for the first time, cameras have been allowed to record the daily dramas at Insite. Inside is a world not many have seen before. In Staying Alive, reporter Hana Gartner introduces us to some of those who work there, including Darwin Fisher, the intake manager, and Dr. Gabor Maté, who has been caring for addicts, prostitutes and the homeless for the past 10 years. You’ll meet three addicts doing their best to survive. There is Dave, a user for half of his 40 years who has been coming to Insite since it first opened and who speaks to the harsh realities of life on the street. And Taz, who comes to the centre to detox and, in the process, confronts her past sexual abuse as she struggles for a better life. And finally, Shelly, who, despite her addiction, wants us to know: “I’m somebody’s kid. I’m somebody’s sister. All I want is for people just to say ‘hi’ sometimes and remember I have a heart that beats.”

Insite‘s future is uncertain. In this CBC exclusive, for the first time, viewers can see inside Insite and make up their own minds.”

Dr. Maté has written a book, In the Realm of Hungry Ghosts

I haven’t yet read this book, so I’m including the review I found online, below.  If anyone has read this book, or is familiar with Dr. Mate’s work, please comment.

“In this timely and profoundly original new book, bestselling writer and physician Gabor Maté looks at the epidemic of addictions in our society, tells us why we are so prone to them and what is needed to liberate ourselves from their hold on our emotions and behaviors. But if Dr. Maté’s patients are at the far end of the spectrum, there are many others among us who are also struggling with addictions. Drugs, alcohol, tobacco, work, food, sex, gambling and excessive inappropriate spending: what is amiss with our lives that we seek such self-destructive ways to comfort ourselves? And why is it so difficult to stop these habits, even as they threaten our health, jeopardize our relationships and corrode our lives?

Beginning with a dramatically close view of his drug addicted patients, Dr. Maté looks at his own history of compulsive behavior. He weaves the stories of real people who have struggled with addiction with the latest research on addiction and the brain. Providing a bold synthesis of clinical experience, insight and cutting edge scientific findings, Dr. Maté sheds light on this most puzzling of human frailties. He proposes a compassionate approach to helping drug addicts and, for the many behavior addicts among us, to addressing the void addiction is meant to fill.

I believe there is one addiction process, whether it manifests in the lethal substance dependencies of my Downtown Eastside patients, the frantic self-soothing of over-eaters or shopaholics, the obsessions of gamblers, sex-a-holics and compulsive internet users, or in the socially acceptable and even admired behaviors of the workaholic. Drug addicts are often dismissed and discounted as unworthy of empathy and respect. In telling their stories my intent is to help their voices to be heard and to shed light on the origins and nature of their ill-fated struggle to overcome suffering through substance use. Both in their flaws and their virtues they share much in common with the society that ostracizes them. If they have chosen a path to nowhere, they still have much to teach the rest of us. In the dark mirror of their lives we can trace outlines of our own.
from In the Realm of Hungry Ghosts

Dr. Maté asks an important question regarding the treatment of drug addiction, How do you measure and define success?

When asked why he finds his work so gratifying and how he keeps himself going in the face of such such tragic, depressing outcomes , Dr. Maté answered that the deep authenticity of his patients is something he could never find in any other pool of patients.  At the point when these addicts enter his clinic, their honesty is so compelling and heart wrenching, that Dr. Maté and his staff will do whatever it takes to give them the care and compassion they deserve and are so desperately seeking.  Their need is  huge,  and the fact that often, Dr. Maté can mitigate their suffering, is a powerful and satisfying motivation for his work.

Maté contends that addicts are almost always abused.  The essence of his treatment approach is one of harm reduction:  to treat the symptoms of addiction and reduce the harm of the habit – that this is a legitimate medical goal. He advocates the decriminalization of drug possession and medically supervised drug use and treatment – that these ‘simple’ societal changes could be a huge economic savings to our entire society, that addicts shouldn’t have to commit crimes to support their habit – and that rehab settings should be comfortable and loving environments that prepare addicts to re-enter society with skills training and psychological support.  This approach to recovery is a  less costly and safer approach, at the very least, and more importantly, is more humane.

I’m anxious to hear from you about some of these ideas.  My own have changed a lot since beginning this blog last September.

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The Deep, Dark Hole

Posted on March 2, 2010. Filed under: addiction, Addiction Resources/Support, Intervention, Parent of an Addict, The Bottom | Tags: , , , , , , , , |

I’m going to be ‘on duty’ for the next week, taking care of my two grandchildren (3 & 5 yo) while their parents are out of the country.  I’m sure I won’t have much time to post on my blog.  But please, still check in.  Especially since Thursday evening, I will be hearing David Sheff, and his meth addict son, Nic, speak at Town Hall in Seattle..  I really enjoyed David Sheff’s moving memoir, beautiful boy, and am looking forward to seeing/hearing him in person.  His son, Nic, about whom Sheff wrote the book, will also be appearing with him.  Nic has written his own book, Tweak, an up close and personal view of meth addiction.  I know that Nic has relapsed several times since his father’s book was published – and since writing his own.  I’m curious to hear the parent/child journey through addiction, and where they both are now.  Check out my beautiful boy book review and book notes/excerpts, and tune in for my impression/reaction to the Sheffs’ appearance on Thursday evening.

In the mean time, if you haven’t visited the Recovery Help Desk blog, do.  Tom, a professional addiction counselor, has good information there and interesting perspectives on a variety of provocative topics.  I’ve been thinking a lot about his post,  Hitting Bottom. It was uncomfortable to read, because it challenged my current position with my daughter and went against what most professionals/groups/literature have said about addicts and their ‘need’ to feel enough pain before seeking help.

After trying to ‘help’ my daughter over the last several months (and years!), I backed completely off  and decided to let her feel the full impact of her life choices, hoping that this approach would jolt her in to seeking recovery on her own.  She’s smart.  She’s resourceful, and I truly believe that she knows where to go to get help for herself.  However, Tom makes a good case for challenging that notion – that ” . . . an opiate dependent person does not have full exercise of their free will.  Their free will is compromised.” And, ” Opiate dependence is powerful enough and the opiate dependent person’s free will is compromised enough, that waiting for the person to “hit bottom” can mean the person goes on to experience HIV infection, Hepatitis C infection, unemployment, homelessness, incarceration, loss of child custody, loss of family relationships, risk of violence, or worse.”

I know all of this.  I am obsessed by it.  And yet, I felt like I had made some kind of personal progress by ‘detaching’ from my daughter and trying the ‘tough love’ approach.  It hasn’t worked.  And one final blow – Tom wrote that the concept of purportedly letting the addict hit bottom,  ” . . . excuses those who sit idly by and do nothing to prevent suffering.”  Ouch.  I must admit, as hard as it has been to ‘sit idly by’ and  ‘do nothing’, it also has brought some perverse relief. I haven’t seen my heroin addict daughter since August 24th, nor been subjected to her dramas, lies, excuses, pathetic state.  This tears me apart, but also provides me with some sort of emotional protection. Is this selfish?  Probably.  But now, after reading Tom’s post about the ill-conceived concept of “hitting bottom”, I’m trying to work up the courage to more actively engage with Hayley.

But, how do I do that? What does it look like?  What, specifically, would be helpful in moving her towards recovery?  To my knowledge, we don’t have many of the resources that Tom references in his article.  However, I did find the only doctor in town who can prescribe suboxone.  I wasn’t impressed with him when Hayley and I visited him last summer.  The doctor was anxious to fill his one remaining open slot (he’s allowed 100 suboxone patients), and suggested that Hayley begin suboxone immediately.  She was covered with abscesses, and he didn’t examine her, or even take her blood pressure.  When I mentioned her abscesses, he ignored my question and moved on to the treatment and fee schedule.  That night, a bed became available at a medical detox facility 150 miles away, so Hayley never went back to the ‘good doctor’.

After reading posts at the Recovery Help Desk, I am more informed and receptive to using diversion medications (methadone, suboxone) to treat opiate addiction.  But how can I help my daughter even get to that point, and care enough about herself to want to move towards recovery?  I have no idea.

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Safety First

Posted on January 15, 2010. Filed under: addiction, Parent of an Addict | Tags: , , , , , |

If you haven’t yet visited the “recoveryhelpdesk” blog site, I suggest you give it a look.  Tom’s regular posts there have provoked me to view drug addicts from a modified perspective:  with more dignity, respect, and compassion.

The article below, Focus on Safety makes more sense to me now, after futilely trying to get my heroin addict daughter in to recovery mode for the past 8 months.  However, since I don’t have regular/reliable contact with her now, I’m wondering how I can convey this message to her – that her safety is the ultimate goal?  At this point, her personal health is my biggest concern and minimizing her risk for infection and unintended pregnancy.  I know I can easily slip in to the rescue mode here.  But who else is ‘out there’ educating drug addicts about harm reduction?  It doesn’t seem to be a part of our community education/outreach programs. 

Healthy Steps: Focus on Safety

by recoveryhelpdesk on January 3, 2010

“Whether or not you use today, your focus should be on safety.”

For most people, recovery means abstinence from the use of alcohol or other drugs. I think this is true of most drug treatment providers.  And I think it is true of most family members and friends of people who have a history of opiate use.  It is even true of most people who are currently using, or who consider themselves to be in recovery.

As a result, the focus of recovery is on not using.  The measure of recovery success becomes whether or not a person uses.  And time itself becomes measured in days sober.  Had a relapse?  Reset the recovery clock back to zero!

But shouldn’t our real focus be on safety?

Think of what it would be like to say to someone you care about, “whether or not you use today, our focus should be on safety.”

How would that feel?  What would that mean?

Focus is a powerful thing.  That one change in focus has great transformational power. For the person in recovery, changing the focus of recovery from use/non-use to safety has the power to transform their relationship with recovery.  For family and friends, it has the power to transform their relationship with the person they love.  For doctors, counselors, probation officers and other professionals, it has the power to transform and improve their life’s work.  Even more, the change to a focus on safety has the power to save lives.

Take a look at the traditional ways we talk about the focus of recovery:

Traditional Focus of Recovery





Now consider a new focus:

New and Improved Focus of Recovery



It’s not that abstinence is not a worthwhile goal.  It’s just that abstinence is really only a means to an end: safety from harm.

All too often, in focusing on the means (abstinence), we lose sight of the ends (safety from harm).  It’s a case of not seeing the forest for the trees.  And the sad truth is that devastating harm often results.

“Abstinence is really only the means to an end: safety from harm.”

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