The Secret Suffering of Parents in the Heroin Epidemic
I write a lot about the problems alcohol creates in our relationships with others, but an even more devastating threat has taken hold of our society: heroin.
The parents I come across who have heroin-addicted children are almost always strangers I meet in passing. I've met them in the grocery store aisles, coffee shops, and in the waiting rooms of rehab centers. Their grief is palpable. They are mourning for a living death. They are half-alive themselves.
"I keep bringing him back to treatment, whenever I find him," one mother told me. "He's out on the streets the rest of the time. I don't know if he's alive or dead. At least when he's in rehab, I know that he's safe."
We are losing our children to heroin.
A Troubled History
Our cultural memory is emblazoned with images of rock star heroin users shooting dope in the 70s and 80s. Or we think of "shooting galleries" in poor, urban areas, (think opening sequence of "Fear the Walking Dead"), where rail-thin, "tragic beauties" swap their remaining scraps of human dignity for a quick fix. This oddly intersects with the broad and misguided perception that heroin is somehow an "inner-city" problem that mostly affects blacks and Latinos - a residue from the racialized rhetoric of the War on Drugs.
Heroin addiction transcends race, class, age, income, gender, and insurance status. Heroin addicts can be found in rural areas, sprawling metropolises, and well-manicured suburbs. Heroin users aren't always just cooking up dope on spoons. They are popping pain pills and shooting medical-grade morphine. They are buying what they think is "Molly" at electronic dance parties and inadvertently taking opioids. They are snorting and smoking heroin, falsely believing that these routes of are somehow "safer" and "classier" than intravenous use. They are partying at college campuses, friends' homes, and in the condos their parents helped them buy.
The Epidemic Next Door
According to the CDC, the rate of heroin-related overdose deaths has quadrupled between 2002 and 2013. Almost half of people who are addicted to heroin are also addicted to a prescription opioid painkiller. And 9 in 10 people who use heroin also use at least one other drug.
The governor of Vermont spent his entire 34-minute State of the State speech in 2014 dedicated to the full-blown heroin crisis in their state, noting a 770% increase in the number of people seeking opioid-related addiction treatment.
Most states are reporting an increase in heroin addiction, but the most rapid increase has actually occurred in the Midwest.
Chicago is coming to grips with its own problems. On October 2, 2015, we had more than 74 people overdose in 72 hours, most likely due to a "bad batch" of fentanyl and synthetic opioid-laced heroin that circulated throughout the city.
Buried in Shame, Paralyzed by Grief
Non-Hispanic white males ages 18-25 who live in large metropolitan areas are currently the most at-risk population for heroin addiction. With such a young demographic, we can assume that most heroin addicts have living parents.
How are parents responding? Most of them suffer in silence, until it is too late, and they have lost their child to overdose or a drug-related death. And the mantle of white privilege has proven to be beguiling for parents. Nearly 90% of first-time heroin users in the past decade were white. When you combine a cultural memory of racialized shaming of drug abusers from the War on Drugs with the "white face" of today's heroin addiction, parents of heroin addicts are left feeling as though they failed to instill morality, willpower, and drive in their children (all of the "character defects" our society falsely ascribed to poor blacks who used crack cocaine in the 80s). Parents are riddled with guilt and shame, believing that they are somehow to blame.
"I would never let that happen to my kid," I sometimes hear parents say. But the fact is that no parent wants their child to become a heroin addict, and most parents will sacrifice anything to prevent their children from succumbing to addiction. What results is a forced silence on the parents of children who suffer from heroin addiction. They are afraid that their neighbors, family, and friends will find out, and that they will be judged as negligent parents.
How it Happens
The gateway for many is having access to prescription pain medication. And it is unlikely that the accessibility of pain pills is going to decrease anytime soon, with the FDA recently approving Oxycontin use for 11-year-old children.
When pain pill users run out of their prescription, they find that the street value of a pain pill ($60-$100 for an 80mg pill of Oxycontin) is far more costly than the street value for a bag of heroin ($45-60 for a multi-dose supply). Switching over to heroin seems like the "better deal" for many users.
A Way Out
Parents of heroin addicts need support and assistance in the same way that parents of a child suffering from any chronic or possibly terminal illness need support and assistance. When we shame parents into silence, we decrease their resources, narrow their coping skills, and force them into isolation. In this way, being the parent of a heroin addict is like suffering a living death: you fear for your child's death, and you are slowly dying yourself.
It doesn't need to be this way. With research-validated Medication Assisted Treatment (MAT) healthcare professionals can provide integrated health care and behavioral counseling to help achieve sustained recovery from addiction. Yet this evidence-based treatment is rarely prescribed due to false ideas about addiction. And in some ways, this fear makes sense - if doctors got their children into this mess, then how are health care providers going to help get them out?
The beauty of MAT is that it does not require an expensive 28-day stay in a celebrity rehab. Inpatient rehab and detox - a big business - increasingly shows evidence of being ineffective, with few facilities that actually implement evidence-based practices, medical recommendations, or integrated treatment teams. California, home of the much-touted rehab industry in Malibu, frequently houses rehabs that misrepresent medical services. One inpatient rehab in Arizona featured several times on the show Intervention provides a vivid and tragic example of this.
MAT can be initiated as an outpatient and is highly effective. Not only does MAT improve patient survival and increase retention in treatment, it also decreases illicit drug use and criminal activity. MAT helps patients to gain and maintain employment, learn healthy coping skills, and reconnect with social support networks. Pregnant women on MAT have better birth outcomes.
Parents searching for effective help too-often find their hands tied, feeling strong pressure not to advocate for acceptance of a treatment that works due to lack of information and stigma.
When we acknowledge as a society that addiction is a public health problem, we can free parents from shame and guilt, allowing them to find a way out. We can acknowledge that parents have done their best, and continue to do so in the face of tragedy. We can offer parents strategies, support, and a plan for taking care of themselves while their child takes responsibility for their own healing. Health care teams can form a healing community so that no one slips through the cracks.
Until we bring this epidemic to light and take responsibility for it as a society, the number of heroin-related deaths and overdoses will likely increase. Parents will continue to suffer in silence. And we will increasingly face the possibility that our own children will become heroin addicts, and that we ourselves will endure a living death. SS