BRATTLEBORO — When I prepared to attend the National Rx Drug Abuse & Heroin Summit in Atlanta, Ga. in April, I imagined that I would learn how other communities around the United States were combating the heroin epidemic by which we are all so affected.
Weeks before the five-day conference, as I began to review so many offerings before me in the program guide, my goals became clear.
In attending, I would be seeking information for my community and for families.
And perhaps I would even find some answers for my daughter's constant struggle: her addicted brain, the deterioration of her life, her homelessness, the tug on her family.
* * *
Our children are supposed to be our family's pride and joy. Well, at least that is one of our first expectations, isn't it?
Then, something goes terribly wrong.
I remember with great clarity that Sunday evening in 1998 when my youngest child said to me, “Mom, I am in trouble - I am a heroin addict.” Those words were crushing, yet I had no idea of the impact on the days and years that would follow.
Addiction represents a tragedy to me, a nearly 20-year journey of personal hell; a direct assault on loved ones.
My two children, now in their late 40s, became addicted in their teen years to a variety of substances, including crack cocaine, heroin, and alcohol.
Yes, they consumed these drugs first by their own hand but then very quickly, they became betrayed by their bodies and then caught, unavoidably, in the cycles of drug seeking that led to lost hopes and dreams and lifelong harmful circumstances.
* * *
Addiction is an insidiously cruel disease that has no boundaries.
Not only does this disease of the brain greatly affect the individual, there is much evidence of the harmful long-term effect on family members, too.
As someone who has watched the deterioration of my children's lives, I have witnessed firsthand the carnage: relationships broken and abandoned with their family.
Left behind are the children - my grandchildren, and perhaps yours, too. Our future.
Speak with any elementary school teacher today, and you will hear the saddest of stories of abandoned children living with relatives or in the state's custody.
Often, opioid addiction has paralyzed two or more generations of a single family. Uprooted from the only families they have known since birth, these young individuals, including my grandchildren and great-grandchild, are paying the price for the disease of addiction.
And in the throes of this crisis, their lives have been changed forever, thus setting the stage for problematic relationships in their worlds forever.
* * *
As citizens who care deeply about our country, the only way through this challenge is for us - we, the people - to demand action from those who can make the difference.
Addiction as a brain disease is relatively new by our thinking, yet the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, published in 2013, the standard medical reference for psychiatric diagnoses) includes substance-use disorder among its list of behavioral addictions.
Years of research now say it is. Yet, how do we remove the stigma attached to that word “addiction”?
To expect someone like my youngest child, my daughter, to have rational, level-headed thinking, to make good healthy choices on her own behalf, is simply absurd.
Her brain long ago was hijacked by her heroin use, and she cannot possibly make any good decision because the voices and noises inside her brain are consumed with using illegal substances.
* * *
In Atlanta, topics were numerous, and the lecture forums were supported by top professionals in their various fields of expertise.
Speakers included a long list of well-respected notables: Surgeon General Jerome Adams, former President Bill Clinton, and Kellyanne Conway, presidential counselor in the Trump administration.
Many scientists from the Centers for Disease Control and Prevention and the National Institutes of Health presented the facts and current figures. Nora Volkow, director of the National Institute of Drug Abuse at the NIH, explained one current high-priority challenge at hand: to research and develop a non-addictive-yet-effective pain medication for those in true need of pain relief.
Initiatives before Congress presented by U.S. Rep. Hal Rogers (R-Ky.), chairman of the House Appropriations Committee, included a bill to help repay student loans for medical personnel such as doctors, nurses, and social workers in exchange for their committing to work up to six years in high-need geographical areas to help with epidemic treatment.
* * *
In one session, “State Leadership on the Opioid Epidemic,” hosted by Massachusetts Attorney General Maura Healey, I was comforted to learn that opioid-related deaths had decreased 8 percent since this same time last year. But I was frightened to learn that 80 percent of the deaths in Massachusetts were related to toxic combinations of drugs such as fentanyl and carfentanil, a powerful elephant tranquilizer found lurking and available for purchase on the dark web, manufactured in China and delivered simply through the U.S. mail.
Ms. Healey went on to say that concern is so high in Massachusetts that the state recently applied for and received a $1 million federal grant to develop a fentanyl strike force. This is serious stuff: the purchase of $6,000 of fentanyl translates to a yield of over $1 million at the street level for dealers and the cartels operating there - and, yes, also here in Vermont.
I listened as she described stigma and the difficulty of obtaining care by comparing people seeking treatment for a broken leg or a heart condition to those seeking treatment for substance-use disorder.
All people, she said, should have the same access to behavioral and mental-health care with a responsibility to be treated with the same respect and honor as those seeking medical or surgical treatment.
Not so much a surprise: that this precept was echoed in nearly every other session I eventually attended. Roadblocks to accessing care are numerous.
* * *
I saw this firsthand when I wandered into the exhibit hall. Sure enough, one display booth after another touted the specifics of rehabilitation programs, all of which, of course, did not come cheap.
When I asked at several booths about state insurance as a means to enter their programs, what do you think they said?
I finally stopped at an attractive booth and inquired about one such program in the Catskills in New York. Cost: $93,000 for three-month residential program, with no “guarantee” at the outset.
Encouragingly, Attorney General Healey referred to her state gaining ground through resources in the Healthcare Systems Bureau, which provides protection for consumers. Her office also works to remove barriers for families in accessing care and treatment.
Also, her state government's efforts to work with the various law-enforcement divisions around Massachusetts to address the crisis have been an integral part of addressing policy, procedures, and laws that need to change for a better outcomes overall.
* * *
As I have witnessed my daughter's revolving-door experiences with the criminal-justice system, I was particularly interested to understand the nature of drug courts. My next session was “Treatment Matters: Best practices for treatment in Drug Courts and the Criminal Justice System.”
The idea of drug courts became a reality as a result of the crack cocaine epidemic in Miami, Fla., in1989. Now, more than 3,500 such courts operate within the U.S. and internationally.
A drug court provides a judicially supervised court docket with a sentencing alternative of treatment combined with supervision for people with serious substance-use and mental-health disorders.
Drug courts take a public-health approach to help addicted offenders into long-term recovery by using the judiciary, law enforcement, social services, and treatment options to allow individuals to get control of their lives and to avoid criminal behavior.
True recovery, of course, depends upon the willingness of individuals to “show up, tell the truth, try their best, and abstain from illicit substance.” The journey to recovery is hard work.
Yet drug courts not only impose sanctions, they also offer MAT (medication assisted therapy) and therapeutic counseling, and they can often follow a medical protocol.
* * *
I also attended “Correctional Based Interventions: Treating Criminal Justice-Involved Populations, State of Kentucky.” Using an ethical approach and innovation to maxed-out systems, this corrections-based program focused on meeting clients where they were in life and applying strategies accordingly.
Because substance-use disorder is a chronic, progressive, and potentially fatal disease, a multi-prong approach is applied. The treatments include cognitive behavioral therapy, therapeutic community model of structure, and contact with spiritual fellowship. Where appropriate, MAT is offered to stabilize the client; without it comes a greater risk for overdose and death. Long-term maintenance may help curb the need for substances down the road.
I saw a film that highlighted one success: a voluntary 12-week faith-based, all-volunteer pilot program offered to incarcerated individuals with substance-use disorder at the Los Angeles County Jail. With volunteers offering peer to peer support, this program met people where there were in life, using a holistic approach, and offering support for family members as well.
* * *
As the final day's programs came to a conclusion, I learned this: communities, individuals must join together to discourage stigma and to work together toward changing attitudes toward substance-use disorders. This is not a new concept.
And, know this.
Cutting agents for street drugs such as heroin, crack cocaine, and cocaine are becoming increasingly more dangerous: fentanyl, carfentanil, hydrochloride, and sulphuric acid. The next wave of concern in this epidemic includes the resurgence of stimulants such as cocaine and methamphetamine use.
In my commitment to my community, I want to continue to make a collective impact through education of the general population about substance-use disorders and especially to continue a focus on prevention geared toward our youth.
I want to continue to encourage family members to seek encouragement and support through active Nar-Anon Family Groups.
Statistics showed me that Kentucky and West Virginia are making great progress in the war on opioid addiction; Vermont was very well represented - probably the highest attendance rate per capita.
Progress is slow, yet moving in the right direction. Awareness has increased.
And, for my daughter, the quest for answers and solutions continue.
“If a mother's love could fix addiction, it would have long ago been eradicated, too many people do not understand this,” writes Iyanla Vanzant, quoted in Tending Dandelions, a book of meditations for mothers with addicted children by Sandra Swenton.
“Your story will heal you and your story will heal somebody else,” Vanzant continues. “When you tell your story you free yourself and give other people permission to acknowledge their own story.”