A multigenerational crisis
Photos of “Annie Rose” and her family celebrate birthdays and other good times amid the constant presence of the opioid epidemic. Rose’s son and daughter both have struggled with opioid use disorder and recovery, and she is one of a burgeoning number of older Vermonters taking over the parenting of grandchildren.

A multigenerational crisis

Across Vermont, children of parents affected by the opioid epidemic are being raised by their grandparents, says one grandmother whose family has struggled with the devastating consequences for decades.

BRATTLEBORO — Annie Rose is driving home from visiting her son, who has been incarcerated for 15 months on a gun and drug charge.

“He's in a minimum-security prison because he's never been in trouble before. I know that he's done illegal things before, but this is the first time he has been caught,” says the 75-year-old grandmother.

Her son turned 54 years old the previous day.

“We talked much longer than we usually do,” reports Rose, smiling. “It was a meaningful conversation today, quite wonderful. I could tell you a whole story about what it's like to have a child in prison.”

Visiting a child in prison is not new to Rose. Both her kids, now in their 50s, have struggled with addiction for a long time - her daughter to such a degree that she's been in and out of treatment for almost 25 years.

They continue to try to give up the drugs they know aren't helping them.

“There are many different substances that made their way into our lives,” says Rose, a pseudonym that she uses out of respect for her son's and daughter's privacy. It's the name under which she is writing her first book, a memoir about the heartache of her family's situation and her attempts to “[turn] the experiences around to try to help someone else in this situation.”

In 1998, when Rose was age 51, her daughter asked her for help and revealed a heroin addiction.

As a result, her grandchildren - then ages 7 and 9 - came to live with her, Rose says.

A few years later, her daughter had another child, who was born with substance in her body, the result of her mother continuing to use while pregnant. Eventually, that grandchild also came to live with Rose.

“When a grandparent first gets involved, there is an element of surprise and then surrender,” Rose says. “Of course, how can I help?, you think to yourself. This is only temporary, and they will go back to their biological parents.”

In Rose's case, they did just that.

“But my daughter and I agreed that they would be better off living with me,” Rose says. “They've never lived with their mother again.”

“It's exhausting,” she says. “There is no respite. You're older than you were when you were first a mother, but there aren't any breaks.”

“Originally, I thought, as a parent who already raised a family, how difficult could this be?” says Rose. “Well, there was so much more to learn at this level.”

Like what?

“You need to be all in,” she says. “You must give up this idea that you are a grandparent and start looking at yourself as the person in charge, the parent.”

Amid this potentially distressing situation, “You need to know that your grandchildren don't want to live with you, they want to live with their mother,” Rose says, noting that grandparents thrust into the primary caregiver role shouldn't take personally their grandkids' distress at the living situation.

“When you are used to chaos, you will crave what you know,” she says. And however much a healthier living condition improves children's lives, it can be “so very different from what your grandchildren are used to - but it's what they know.”

There are also lots of logistical challenges, Rose adds.

“For example, I went to court to receive guardianship of my grandchildren so that they could be enrolled in school,” she says.

But to do so requires the approval of both biological parents - for Rose, a situation fraught with complications.

“You have two children, the mother isn't allowing the father to see the children, but the father didn't do anything about that,” Rose says.

That's one example of the logistical, emotional, and legal challenges faced by those who are thrust back into the role of standing in for the parents of young children.

'Members of a club'

In Vermont, more than 6,000 grandparents have custody of their grandchildren.

“I think about the numbers of grandparents who have had to come out of retirement suddenly - people in their 70s and 80s,” Rose said.

As a result, the state Department of Children and Families is overwhelmed.

Out of this demand for support, a grandparents' support group emerged.

“We became members of a club which we never felt we'd be a part of,” Rose says.

“In the last 20 years, little has changed except that more and more grandparents have been touched by addiction in their families,” she says. “It's epidemic.”

Realizing no help was available locally for families struggling with addiction, Rose developed a local chapter of Nar-Anon, a support group for families dealing with addiction, 22 years ago.

“We have a core group of people, all bonded by addiction and our kids,” she says. “It's a big subject. My attention has always been not focusing on the addict, but on the families.”

“You can survive it, but you must take care of yourself and not focus on trying to make the family member do things they don't want to do,” Rose continues. “Patience is something that has come along at a later age for me.”

At Nar-Anon, “we support one another,” she says. You can survive it, but you must take care of yourself and learn to just stop trying to make the addicted person do things they don't want to do. That simply doesn't work.”

Rose is filled with compassion for those who suffer with addiction.

“I was turning onto a street in downtown Brattleboro a few days ago,” she says. “There stood a man, holding a paper bag in his hand.”

She describes the man as “a zombie - so much so, he couldn't move.”

“I've heard the stories of other families, and I've seen and lived this issue myself,” Rose says. “And yet, when I look at somebody who is impaired, I think about that person and see somebody's bundle of joy.”

Where is that man's family now? she wonders, imagining him as “a valuable family member at one point.”

“That's always where I go,” she says. “It's so sad what addiction takes away from both the addict and their family.”

How does Rose do it? How does she care for herself while caring for so many others?

A cancer survivor, she takes pains to take care of her body and her mind, knowing the personal toll addiction takes on family members.

“I stay in close contact with my many friends,” Rose says. “My high school class friends are still tight, even after 60 years.”

She connects regularly with former classmates, “even some friends I first met in kindergarten,” she says. And, she has found, “there are so many of us who have experienced addiction in our families.”

Educating 'the most vulnerable'

Vermont is about to receive more than $100 million dollars in settlements from a number of lawsuits filed against a variety of corporations whose aggressive and deceptive marketing of prescription opioid drugs, which were portrayed as non-habit-forming despite evidence to the contrary.

Even more money might arrive as other lawsuits are settled or litigated, said Rose, who has some ideas about how Vermont should be spending those funds.

“Our state has access to financial awards from big pharma, all of which needs to be distributed to all Vermont communities based upon a need,” Rose says. “Yet, these dollars can get stalled in the bureaucracy of studies, and statistics, and committees, and talking heads all the while people are desperate, desperate for support.”

“There is no winning the war on drugs, but I believe each community can be aggressive in their approach to save their citizens and at the same time - most of all - educate the most vulnerable: our children,” she adds.

Rose suggests that at least some of the money go toward educating young people about drugs.

She comes to that conviction from her family's own journey, starting in the 1970s, which she describes as “an innocent one in our country.”

“We didn't think about drinking and driving, we didn't think a lot about our children getting involved in drugs,” she says. “It was trendy in the 1970s to smoke a little pot, and to get involved with alcohol. The drinking age was 18.”

She says that her ex-husband, from whom she was separated since their kids were 4 and 6, was a permissive parent when it came to drugs and alcohol, and that proved to be their son's gateway into his struggles.

“By 1980, when my son was 12, he started smoking marijuana,” Rose says.

Eventually, her son “went from pot to alcohol to cocaine.”

“I will have the conversation with anyone who says that marijuana isn't a gateway drug,” Rose says. “I believe it is.”

Rose learned first about her daughter's struggles even though her son, the older of the two, was involved in drugs before she was. “I wasn't as trained to see what was happening then, and he kept his addictions under the radar,” she says.

Drugs did not enter her daughter's life until after the birth of her second child. She, too, started with marijuana.

“Let's develop a program to bring information at a level that children can understand,” Rose says. “Gathering schools and communities together, getting information out, so that young people know the pitfalls of using drugs, and the kind of things that have happened in our society because of drug addiction.”

“Maybe some children have family members who are in jail because of drug-related activity,” she says. “Maybe they have lost a relative to addiction. We need to get programs into our elementary schools so that children are told in plain ways what happens to your body and to your life when you get involved with drugs.”

Rose says the goal is to have children - who will always flirt with danger as part of their journey to adulthood - stay away from using drugs as long as possible.

“The brain begins to mature in the 20s, and there is less likelihood of addiction later in a child's life,” Rose says. “We need to educate youngsters, and we need to educate families so that they know what they are looking for if a child begins using.”

Rose notes that without this type of information and knowledge sharing, we are simply setting up the next generation of drug abusers.

“At this point, lots of these kids have families where their parents are in jail,” she notes.

Meanwhile, “the people who go into the professions of wanting to help people, nurses, doctors, social workers - these people invest themselves in helping people with addiction issues,” he says.

But they never see change.

“It's the same people coming in, going out - it's a revolving door,” Rose says. “'We have a broken system that is escalated by homelessness, and a mental health crisis.”

Still, Rose finds some hope in research on a new way to administer naltrexone, the medication used in medication-assisted treatment to prevent people in recovery from relapsing into drug use.

One paradox of recovery is that people participating in such programs face struggles with an unstable life and can be overwhelmed with issues of transportation, housing, employment, and sheer survival. The act of getting to a designated place and time regularly to get the essential medication does not help someone trying to remain substance-free.

Recent clinical trials at Columbia University have begun to study the effectiveness of delivering sustained doses of the medication in a new way: as an implant that would need to be administered only monthly.

Struggles, successes, and stigma

Rose's grandchildren are growing up, and the effect of the opioid epidemic on their family has reverberated throughout their lives.

You can see pockets of gratitude on social media, where one granddaughter described Rose as “one incredible, loving, supportive, strong woman” and said, “I wouldn't be who I am today without you.”

But Rose says that her daughter's children will not speak to their mother.

“Imagine the shame and embarrassment to read about their mother's bad behavior in the local newspaper,” she says. “How difficult for a young child to cope with the public reference.”

“At one point, my granddaughter decided to say she lived with her grandmother because her mother was dead rather than endure the constant barrage of questions from classmates,” she continues.

Rose is the one figure in the eye of this emotional hurricane.

“I try to foster communication, and I speak with everyone involved, but I never tell people what to do,” she says.

“I cannot imagine what it would feel like to be abandoned by your mother,” she says, looking at the situation through the eyes of her grandchildren.

She also can see it from her daughter's perspective.

“She gave up her third child to me,” Rose observes. “That was both a selfless act yet traumatizing at the same time.”

Amid the pain, Rose also sees some hard-earned glimmers of success.

She says her daughter has persevered and “has managed to overcome a lifestyle that had brought her and us to our knees.”

Her daughter has become “very successful at this point in her life” as an entrepreneur, she says with pride.

“I'm proud to say that she has adopted the same work ethic as her grandparents and the way I live my life,” Rose says. “She has advanced her life. She has made better choices.”

But it's all one day at a time. Rose's daughter began a methadone maintenance program while in a residential treatment program.

“I don't know if she is still on it,” Rose says. “I meet my kids right where they are. I don't ask imposing questions.”

'Walk outside your door'

Because the opioid epidemic is “not going away, it's getting worse,” Rose believes that new measures need to take place to “expose real, unnecessary death, in real time.”

“We must keep this epidemic in the public eye,” she says.

“If your life hasn't been touched by addiction, you may not want to look at it and not want to know about it,” Rose continues.

But, she says, the problem isn't going away. And central to the problem is the elusive answer to a simple question: “How do you get someone under the influence to want to change their ways?”

“Walk outside your door,” she says. “It's here. We're never going to see our way out of addiction, there is too much money to be made.”

Rose pauses.

“And yet, I also feel the solution can be found right here within our own community,” she says.

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