Turn on the radio or TV news today and you will probably hear something about America’s epidemic of drug abuse. Opioids (a class of drugs that includes prescription medicines like oxycodone and fentanyl as well as the illegal drug heroin), are at the forefront of the discussions — and perhaps justifiably so. Opioid-related deaths are increasing at an alarming rate, reaching 50,000 in 2016. It’s a public health issue of considerable proportions, and one that our society should and must take seriously.
But drug abuse is not a simple issue. And it’s difficult for me, as a healthcare professional, to watch our legislators and policymakers treat it as such. Since the abysmal failures of Prohibition and our nearly 40-year long “War on Drugs,” it seems to me that we should have learned by now that laws and regulations merely drive addiction underground, where it’s more difficult to detect and treat. What’s more, criminalizing addiction is as ineffective and barbaric as criminalizing diabetes or heart disease. All three are lifestyle illnesses, yet we treat two of them with medicine and supportive care, and throw the victims of the third in jail.
Millions of Americans suffer or know someone who suffers from a life-threatening addiction. My mother died at the age of 60 due to complications of alcoholism. Her sister and her father died of the same disease. All three knew that their drinking was killing them. My mom also promised dozens of times that she would stop. As her disease progressed and her liver failed, she even swore to me and my brothers and sisters that she had. Yet after her death, we found empty liquor bottles stashed in nearly every nook and cranny of the house.
My mother didn’t want to die. But like all addicts, she was powerless to stop her behavior on her own. Her motives for not seeking help long before her illness took her life will always be a mystery to me. But I believe they were rooted in our nation’s anachronistic view of addiction as a shameful character flaw rather than a complex physical, emotional and social disease.
Adrianne was a 30-year-old mother of two young children. Her daughter, Amanda, is now four, and her son Todd just turned two. Adrianne worked part-time at a local convenience store, and all of her friends called her a “great mom.” She was pretty and vivacious and seemed very much in love with her husband of 10 years, Tom. No one in her immediate circle suspected that she was addicted to drugs and alcohol until the morning she ran her car off the road and into a ravine. She died several hours later in the ICU. An autopsy revealed she had a blood alcohol level of 0.18, over twice the legal limit, and had been using cocaine.
After Adrianne’s death, Tom opened up about her struggles with drugs and alcohol, which had been going on for years. Like many women who become addicted, Adrianne had been sexually abused as a young girl, and that early trauma haunted her throughout her life. She started drinking at 13, but stopped for a while after she met Tom. She didn’t drink or use drugs during her pregnancies. And she remained sober until six months after her second child was born, when financial pressures forced Tom to take a second job.
“Maybe she was lonely,” Tom says, looking bewildered and sad. “Maybe I should have stayed home more and helped with the kids…Would it have helped? I don’t know,” he said, covering his face with his hands. “She always seemed to do really well and then she would just fall apart.”
Tom and Adrianne’s experience was not an unusual one. Many addicts go through long periods of sobriety only to relapse when some triggering event occurs. Sometimes it’s an external stress, like being fired from a job or a divorce. Sometimes it’s something internal — an emotional crisis of some kind. Many people who suffer from addiction also suffer from a mental health disorder that may influence their need to use drugs. And many family members struggle with feelings of guilt and regret when relapses occur, thinking, “What should I or could I have done?”
The National Institute on Drug Abuse defines addiction as “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. It is considered a brain disease because drugs change the brain; they change its structure and how it works. These brain changes can be long lasting and can lead to many harmful, often self-destructive, behaviors.”
What this means is that addiction in all its forms is not a failure of will. It is not a character flaw. It is not a sign of weakness or lack of self-care. Nor is it, as it is often called, “slow suicide.” People who are addicts are not killing themselves. Their illness is killing them by driving self-destructive behaviors they cannot control.
If you or someone you love is struggling with addiction, I urge you to seek help. Speak with your doctor; contact a mental health professional or reach out to your local chapter of Alcoholics Anonymous or Narcotics Anonymous for support. Treatment is available, and it can work. Even if the person who is addicted is not open to getting help at this time, there are resources available to help you and your family cope with the disease.
About Kathleen
Each month Kathleen Clohessy, R.N., offers a new perspective on living with a terminal illness. Kathleen comes to SevenPonds with 25 years experience as a registered nurse caring for families and children facing life-threatening illness. She began her career in the Pediatric Intensive Care Unit at Nassau County Medical Center in New York. After relocating to California, she spent 15 years as an R.N. and Assistant Nurse Manager at the Pediatric Oncology & Bone Marrow Transplant Unit at Lucille Salter Packard Children’s Hospital at Stanford. She uses her knowledge and expertise to enlighten our readers about the challenges associated with chronic illness and its effects on family relationships.
We sought help and those who were supposed to help both made the problem worse and did not provide any chance of recovery. Our medical system is all about dollars and cents. Plus there is the underlying belief that it’s the addict’s fault. We sought help over and over during my son’s last months and real help was never provided. What you say is right—what is done for our loved ones who suffer the disease of addiction does not come close. My son was given more drugs to cure his addictions and those prescribed drugs led to more cravings and killed him.
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Patricia, I am so sorry for the loss of your son. I look forward to a day when our society and policymakers begin to see that the “cure” for addiction isn’t laws and “prescribing guidelines” but research into causes and cures. We know next to nothing about the neurobiology of addiction, and until we do, “treatment” is going to remain the same…a slapdash approach that sometimes works but all too often fails. My heart goes out to you and your family.
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My husband died at age 48, the result of many years of addictive behavior. At the end it was alcohol–easily and legally obtained. He was extremely intelligent and outgoing–neither of which have anything to do with resisting addiction. The majority of people who knew him had no idea how much he drank or even that he was an alcoholic. Even I, as his wife, wasn’t sure how much he consumed on a weekly basis. It is easy to assume that you know everything about the person you live with but the reality is that we learn only what is shared. Belief in the possibility of quitting is essential–it doesn’t matter how many rehab stays there are.
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We have to look at social and economic causes of addiction as well. Last year my daughter lost one of her closest friends to an OD. The young woman was 22 and left behind a mother and brother who adored here along with many friends. Her funeral was three days before Christmas. I’ll never forget the wail her mother made when it came time to close the casket and she finally understood that she would NEVER see her daughter again.
What happened? She was a headstrong and rebellious girl from a family without much means in an area with few opportunities for young people. She shoplifted occasionally and could be carelessly defiant but she had a good heart and wanted to be an elementary school teacher. However, she couldn’t really see a means to that end and worked customer service jobs while she partied for fun. At one of those parties someone introduced her to heroin, and that was that.
These young people need guidance and a light at the end of the tunnel that will keep them on the right track and away from the pit of substance abuse, and that’s lacking in many places. Maybe if my daughter’s friend had recieved that she would have been okay.
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I am sorry to hear about your friend’s daughter. It’s a tragedy when a young life ends so needlessly. And I wholeheartedly agree that hopelessness and economic disadvantage fuels addiction in young people and — more and more–older Americans who are finding themselves stuck in impossible situations with no way out. Our society needs to address the underlying social and economic issues that lead to addiction while simultaneously implementing effective treatment strategies. Without both components we will never make the kind of progress that will save lives.
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Well, there have been some improvements but not enough.
I. There is the good samaritan law that enables those who overdose to be given treatment without punishment.
II. Oregon, and possibly Washington, have decriminalized hard drugs which will enable people to get help.
III. There are a few places where folks can get good (uncontaminated) dope.
IV. Involuntary commitment has helped some opioid addicts.
V. Some rehab places are publicly funded.
VI. Medication management in which clonadine is used to treat withdrawal, and suboxone/butanorphene are used to treat addictive cravings is of benefit.
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Hi Geoffrey,
Yes there has been some progress, but it’s agonizingly slow. For heroin addicts, MMT is by far the best option, but the need far exceeds the number of clinics available, and getting the addict to seek treatment is a challenge of its own. Now, with the COVID pandemic in the forefront of public health initiatives (as it should be!) I fear the opioid crisis and all mental health programs will be neglected for a while.
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