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Day 1: The Call

My son calls me from a city far away where he has gone for an athletic competition. When I see his name flash on my phone, I think he is calling to say he is about to compete, and I will wish him luck, and he will thank me for my support, and I will tell him I am proud of him and happy for him – all the usual things.

But he is calling to say he cannot compete. He went into full opiate withdrawal before the competition, and then, in the city far away, he went to a methadone clinic. It was closed. Outside the clinic, he bought black tar heroin.

You took heroin? I ask. I am thinking there is some mistake. I am thinking that a hole has opened and swallowed the world. At the same time I am thinking, people can take heroin once. The first time can be the last time.

But it will turn out this is not the first time. In fact, he has been taking it for a month or more. Not the first time, not the last time.

In the beginning, several years before this call, he took Percocet or oxycontin three times a week at work. He said he respected the drug. He would never use the drug outside of those times. It was a work aid. And I let myself be lulled by this. He was an athlete, always reading about health and fitness, citing the benefits of various supplements: “This is not bro-science, this is from a peer-reviewed journal.”

But about a month before the call, I started to notice. Something had changed. Sometimes when he called, his voice was slurred. When we met for dinner, he kept going to the bathroom. In my journal, I wrote, Does my son have a drug problem? But I couldn’t bring myself to ask him. I was too afraid of the answer.

The question itself was the answer.

On the phone, he says he needs to go to medical detox as soon as he comes back. He asks if I can find out about detox. I say I will find out about detox.

I hang up and call my sister, who has been clean and sober for years. She says, It doesn’t seem like this now, but this is the best thing that could have happened. I know what she means. She means this is the first step to recovery. But it does not seem like the best thing. It seems like the exact opposite.

I call to find out about medical detox. I write down the numbers. I call friends: my oldest friend, my friend who is in Al-Anon, my friend who knows people. I try to hold onto my sister’s reassurance. This is the best thing. It’s out in the open now. This is the first step to recovery.

But the day of the call is not today. It has been 34 days since the call. In those 34 days, there has been a first treatment attempt with Suboxone, a switch to methadone, a decision to stop using methadone and start using heroin again. (Note the avoidance of pronouns.)

In those 34 days, there has been hope and despair and terrible fear. My son dying of an overdose. My son in jail. My son suffering the innumerable consequences of addiction.

It still seems like the worst thing.

Today I decided to write this diary. I am a writer. I don’t know what else to do.

Round 2

I dream that the new puppy has bitten the new kitten. I am late for work, and my phone has turned to putty in my hands; pieces of it break off when I try to use it. I can’t ask my 26-year-old son to look after the new puppy — the puppy he brought home and promised to look after — because he has developed a new and very active addiction to alcohol and cocaine.

Parts of this dream that are not real:

  1. We don’t have a kitten.
  2. My phone is not made of putty.

Day 365: Year

Where will I be in a year?

Over a year ago, I sat in this room and cried. Addiction is my enemy, I wrote in my journal. And I meant it.

In the last year I have learned that my enemy is actually human and ordinary, built into the same neural circuits that make learning possible. To get to this realization, I learned some brain science – not a lot (and certainly not very well), but enough to bore a whole tableful of dinner guests.

This year I have learned the importance of better listening. I still have to remind myself to ask more questions. Say fewer sentences. Luckily I have plenty of opportunities to practice.

I don’t believe words can make people sober – magically, automatically, merely through the act of one person uttering and the other person hearing. But I believe words connect us and keep a light on in the dark. People with addictions are suffering; they suffered before the addiction, they suffer in the thick of their desperate, destructive use, and they will suffer as they recover; they need connection and a light left on more than anything.

I also learned that if you write about 250 words a day, at the end of a year, you have enough words for a book.

Tomorrow, I will follow up with my son and encourage him to call the therapist, to trace the sources of his pain and discomfort, to learn to sit with himself, to keep figuring out how to be in this world. I will keep learning how to do these things myself.

Today I would like to thank my readers. Thank you and thank you and thank you for reading. Thank you for your kind words and your wise words, for connecting and counselling and keeping a light on in the dark.

I text my son: let’s get together and write something.

He texts back: yes, let’s do that.

Day 364: Empty

“I think I want to start therapy,” my son texts me. He says he has lost his ability to sit with anything uncomfortable. “I hate that I can feel empty when nothing is wrong.” He is terrified of the depression returning. “I mean terrified terrified,” he writes.

He says he feels like he has an addictive personality, even though the research says there is no such thing as an addictive personality.

I tell him what Aristotle said: we are what we do. To change what we are, we change what we do. I send him links to two psychotherapists.

Day 363: Agency

No one chooses to become an addict, but addiction is built on initial decisions (I decided to try, I decided to take, again and again). Recovery is also based on decisions (I chose to try, I failed, I tried again, I chose to disclose, to ask for help, to keep trying).

We have to acknowledge that some choices are easier than others. Turning down banana cream pie is easier if you are largely indifferent to pale gelatinous desserts. Turning down anything is easier if you can take it or leave it. It’s much harder to leave it if, the first time you took it, it bathed your brain in unimaginable pleasure, and now it floods it with desire, golden-red and hot and loud, very loud, the pleasure having disappeared somewhere (but where?) along the way.

Some choices are made of a thousand earlier choices. For good or for ill.

Some choices are made by circuits in our brain before we even put them into words. (I was already out the door before I realized where I was going.)

Some choices we make not because we don’t have options but because the options are terrifying. (If I stop taking this, I will have nothing to help me, I will return to the nothing I had before.)

Some choices need to be translated before we can understand them (how can I give up my best friend, the deepest truest kindest love of my life, how can I, how can I?)

Some choices need to be understood before they can be changed.

Some changes take a long time to become visible to the naked eye.

Day 362: We Need to Stop

We need to stop arresting people for taking drugs. We don’t arrest people for gambling away their paycheque, or eating 3,000 calories in an afternoon, or drinking a bottle of vodka a night.

We need to stop sending people to jail for their addictions. We don’t send people to jail to punish them for their diabetes or their depression. In fact, we don’t punish people for their diabetes or their depression.

We need to stop telling people there is one way to recover, and if it doesn’t work for them, it’s their fault, because they’re doing it wrong, because they don’t really want to recover. If a medication doesn’t work on a person, we don’t tell them it’s their fault, they just have to keep taking it better.

We need to stop shutting down safe-injection sites under the pretext that they keep people away from treatment options. We don’t shut down emergency rooms under the pretext that they keep people away from their family doctors.

We need to stop operating in the dark.

Day 361: Syntax

Addiction: a sentence of unproductive repetition, built on the grammar of diminishing returns, around the present continuous returning to the street, the liquor store, the slot machine, the website, always seeking a modifier (change me, quick). Addiction is an act of subordination: I am doing this, even though I am losing all the things I love, even though I want to stop. Recovery might be a matter of changing the syntax: even though I am doing this, I want to stop.

Day 360: Recall

I feel unwell after a vaccination and my son brings me vegetable soup and a cold-pressed juice of beet juice and ginger. He serves the soup (delicious) and encourages me to drink the elixir (foul). We talk briefly about this nice reversal of roles, remembering when I was the caregiver and he the recipient. He recalls the nights that he slept on the sofa and woke in tears, unable to see an end to his suffering. He says, “I would not live through that again for any amount of money.”

Nor would I.

Day 359: Hard Core (2)

I can see why a family in crisis wants a medical facility to intervene in an addiction, why the family wants to involuntarily commit someone who refuses help. For the family, this is a sirens-screaming life-or-death situation.  For the medical facility, it is business as usual.

Voice at the end of the line: Is your child a danger to themselves or others?

Parent: Yes. My child is using a dangerous substance every day.

Voice: That does not count. By danger, we mean: has your child threatened to kill herself?

Parent: No. But my child is killing herself, a little bit at a time. Does that count?

Voice: It does not count. A little at a time does not count.

Parent: What about all at once? She could die all at once of an overdose.

Voice: Has she threatened to kill herself by overdosing?

Parent: No. But she doesn’t care if she lives or dies. Does that count?

Voice: It does not count.

This is not a story of the heartless bureaucracy and its draconian rules. It is the story of a family in great need, stunned, panicked, battered, desperate for immediate help, for a safe place for their child in crisis. Safe meaning secure, locked, but also warm and forgiving. Staffed by skilled people. Available now.

Take our broken child, the parents cry, and hold her. Just hold her, the way we used to.

The medical facility says, We have no jurisdiction.

Day 358: Hard Core

My son tells me about the brother of a friend: unmedicated mental illness, use of multiple drugs: fentanyl, meth, crack, alcohol. He tried to switch himself to Suboxone, but took it too early and went into precipitated withdrawal (apparently worse than regular withdrawal), so now he is back on opioids. He is volatile, infuriated, a young man bellowing in pain on a downtown street.

A mother online writes that her son is living in the bush. He has had an addiction for many years and does not want treatment. He is very clear about this. She uses the word “adamant.”

Another mother uses the word “entrenched.”

Another mother comments: We have to find the positive in these hard core cases, because the alternative is too terrifying to think about.

This alternative is what is haunting my son’s friend: that his brother will die — of an overdose, in a fight or a fall. He wants to know: is there some way to get him admitted to rehab or a hospital against his will?

Involuntary admission requires that he be deemed a danger to others or himself, I say, and we are silent, my son and I, thinking about this. He is a danger to others and himself, but not the right kind of danger. He is a young man with a criminal record, an undiagnosed mental illness, an addiction, and no parents with chequebooks (no parents at all). He is more likely to see the inside of a jail cell. Which will not help. Which will further entrench the problem.

Our hard core problems start at the core.

 

 

Day 357: Continuum

I checked in today with Marc Lewis’s blog – I’ve found his writing on addiction to be extremely helpful and hopeful – and read his post on addiction as a continuum, rather than a disease you have or don’t have, with intensity, duration and riskiness determining your place on the spectrum of problematic use.

Lewis points out that people prefer the disease model because it makes addiction easier to think about. For a long time, I accepted the disease model. It was certainly better than the  moral-failing model it replaced. But our views of addiction still carry the taint of that earlier model, and the disease model also allows us to separate ourselves from people with addictions – they have it, we don’t.

When I began this blog nearly a year ago, I wrote about my own problematic relationship with food. Compared to my son’s use of fentanyl, my own compulsive behavior was low-risk and low-intensity (although of longer duration – perhaps because of the low risk and intensity), but anyone observing us could see that we were following the same pattern – trying to deal with an emotional state by compulsively blunting it.

Much of the stigma and fear surrounding addiction would be drained away if we acknowledged how many of us are on this continuum — and why.