He’s Home. Now What?

Cc photo Kevin Steel on flickr-28912555-original

Creative Commons photo by Kevin Steel

My son was released from jail last week, much sooner than either of us had expected. I wasn’t ready for this. I’ve been doing so much reading and research on addiction and recovery since his last overdose, hoping by now to have mapped out some course for moving forward.

But I have nothing. No clue what to do.

The more I read, the more confusing it becomes, the less decisive I feel, and the more hopeless it seems, at least for finding a clear-cut path to recovery.  At best the path seems murky, fraught with pitfalls, forking out in a dozen directions.

What I’ve learned is this: There is no clear-cut path to recovery for the addict and his family. Every addiction is different and so is every recovery. Outpatient programs, it appears, can work as well as residential rehabs.  And some addicts recover miraculously “on their own” with no program, no treatment, not even a “come to God” moment.

Abstention isn’t always on the road to recovery either. Some never stop using, they just learn to manage it better, learn to moderate and weave their drug use into a productive life. NA and AA while helpful for some can be harmful for others. The only definitive answer I could find was that Suboxane, a drug that blocks opoids and eases craving, is the safest and sanest path to recovery for heroin addicts. Yet its use is almost unanimously frowned upon by most of the “affordable” and state-funded programs.

The only thing I know for sure is that we can not afford the kind of science-based long-term residential rehab program I had hoped to find. We’re stuck with that cluster of worn-out, already-tried, faith-based, less-expensive options. The ones that treat addiction not as a disease but as a moral failing and treat addicts as weak-minded losers who need a huge dose of “tough-love” (translate stern lectures and a cold back) and “humility (translate debasement).  The kind of programs that kick you out if you relapse, or miss meetings, or commit other minor violations. Or they send you to county jail for the same mistakes if you happen to be “on probation.” The kind that prohibit Suboxane.

That’s where my son has ended up (again), on probation and mandated to a Prop 36 program: a well-intentioned program that is completely lacking any scientific or medicine-based or therapeutic style of treatment. Mostly it consists of group meetings, a few films, once a month one-on-one counseling, random testing, and weekly visits to court where he will sit for long hours on wooden benches waiting for his two-minutes before the judge, who will either say “good boy,” or “need a little time-out in jail.” This “treatment” didn’t work the first two times he was in Prop, but hey, maybe it will this time.

So no, I’m not hopeful.

The only hopeful thing I had going was knowing that at least he’s coming home clean and sober, optimistic and enthusiastic, ready to make a fresh start.

But no. That wasn’t to be either.

When I picked him up at the bus station I had the uneasy suspicion that he was already using, or maybe he’d never stopped. Maybe he was using the whole time he was in jail. Maybe the packets of extra food and coffee that I purchased for him because he “was starving” went toward drugs.

Or maybe, like so many times when he was released, someone saw him walking down the road toward the bus stop with his little paper sack and, identifying him as a kindred spirit (they’d done time, they knew how it felt to get out), they pulled over, offered him a ride, shared their stash. Their good deed for the day.

Maybe I should have picked him up from jail rather than making him catch the bus to where we live. Maybe.

So many maybe’s. The only thing I know for sure is that I know nothing for sure.

And when it comes to addiction, no one else does either.

Parity for Drug Addiction Treament – A Distant Dream

Cc photo by Bohringer Friedrich 398px-AchdammSport

Creative Commons photo by Bohringer Friedrich

Under the current healthcare system, quality affordable healthcare for addiction treatment is not a reality for most families in the United States. Only premium healthcare providers cover state-of-the-art treatment for addiction, including long-term residential programs based on the latest brain-based research.

While the Affordable Care Act is vastly superior to what we had before, it still creates a system that discriminates against low-income or no-income patients, that is 99% of people suffering from severe, long-term addiction disorders.

Expanded Medicare will pay for some treatment for the destitute, but it does not include residential programs, nor many of the state-of-the-art therapies available to the 1%.

Recently a brave but grieving family spoke at a briefing held by the House Caucus on Addiction, Treatment, and Recovery. Bill and Margot William’s full story and statement can be read on their website HERE.

They tell of how their 24-year-old son William died of “acute and chronic substance abuse” which caused “complications of acute heroin intoxication”. And how they donated his body to the Columbia University’s College of Physicians and Surgeons for research, to help others suffering from substance abuse disorders.

Bill writes:

William’s cause of death could have been listed as “Institutional Indifference”.  Failed insurance, clumsy coordination between health care providers, and antiquated treatment practices doomed him.

In another time, in a better era, William might have entered the College of Physicians and Surgeons, not as a cadaver, but as a gifted and talented young man, prepared to serve others.

He continues:

Ignorance about substance use disorder remains the order of the day. It is the plague of our time. Anything we say that is repetition bears repetition until it manifests itself as policy change and practice of substance and consequence.

Parity is about more than receiving equal health care insurance for substance use disorder and mental health issues.

Parity means an individual can say, “I have a substance use disorder,” without discrimination, judgment or censure.

Parity is when family members can stand beside the afflicted and say, “…and we are all getting counseling and support to aid in our loved one’s recovery.”

Here is his list of what parity means:

  • Parity means that substance use disorder is recognized by laymen and professionals alike as a brain disease.
  • Parity means that funding for research for substance use disorder is on the same level as that for heart disease, cancer, or diabetes.
  • Parity means that people with substance abuse disorder are treated with the same compassion and understanding, treated with the same urgency, accorded the same dignity, as any other patient with any other medical or surgical need. 
  • Parity is when physicians, not health insurers practice addiction medicine, when physicians, not actuaries determine the best course of treatment.
  • Parity is when physicians are trained to recognize and treat substance use disorder in medical school with the same rigor given to any other disease.  
  • Parity will be when physicians in any specialty can recognize, treat, or refer patients to a proper source of treatment. 
  • Parity will be when there are sufficient numbers of physicians board certified in addiction medicine.
  • Parity will become practice when more than a mere 10% of the 23 million plus Americans who suffer from substance abuse disorder are properly diagnosed and treated.
  • Parity will come about when rehabilitation facilities have medical doctors on staff, all the time.
  • Parity is when physicians, politicians, school principals, police and parents all realize that not only are they responsible for helping to treat this disease, but also that they and their families are as susceptible as anyone else to being afflicted by the disease.
  • Parity will arrive when we stop pretending will power is a cure for a neurological problem.  Will power needs to be exercised, not by the afflicted, but by policy makers who can help change the course of this epidemic.

I would add to that list:

Parity means that all who suffer from substance abuse disorders receive the same quality healthcare options for treatment, regardless of their income or ability to pay.

Thank you, Bill and Margot, for speaking out and sharing your story with us.

I hope that all of us reading this will stand with them in this fight for parity.

 

Rants and Rage and the Bright Rush of Wings

Archilochus_colubris_Illinois_(6155782912) Creative Commons Jeffrey W FlickrMost of the posts that I try to write for this blog disintegrate into dark rants and rages.

Rants against a society that fully recognizes how an epidemic of addiction is destroying our children, our families, whole neighborhoods and cities, filling our jails and prisons, and littering our streets and alleys with the living dead.

And yet, and yet, how this same society provides painfully few resources toward treatment and recovery. A son or daughter seeking a bed at a detox center is forced to wait months for something affordable, dole out thousands of dollars for a few short days, only to be turned out onto the street again when the stay is ended.

Rages against the fact that the few available programs designed to help recovering addicts will bankrupt most families, since the road to recovery, as all admit, includes multiple relapses. But instead of sticking with those who relapse, helping them when they most need support, these programs kick them out on the streets again. With no place to go, to start over again and again and again, with no end in sight.

Sometimes it helps to rant and rage. And sometimes it just creates a dark hole that sucks me ever deeper into despair.

That’s where I’ve been heading. What I’m resisting.

What helps is knowing that I’m not alone. That I’m not even worse off than most.

At least, I tell myself, my son was not gunned down in his first grade classroom by a half-crazed boy; he did not hang himself because he was cyber-bullied into thinking he was worthless; he was not hit by a drunk driver on his prom night; he was not blown up on the battlefield in a senseless war; he was not shot in a movie theater for texting his daughter; he was not lost somewhere over the Indian Ocean on a flight to Malaysia.

At least he was not sold into slavery as a boy in the Philippines; or forced to murder his family as a child-soldier in Somalia; or bombed by a wayward drone on his way to a wedding somewhere in the hills of Aden.

Somehow it helps putting personal suffering into perspective. None of us are free of suffering. Even if what makes us suffer is the suffering of others.

Suffering is not the point, we soon come to see. It’s not what matters most. It’s not what breathed life into us, what keeps us moving forward, or what makes our lives worthwhile—the lives of those we’ve lost, and the lives of those still here, and those still waiting to be born. We do well not to dwell on our personal sorrow any more than we must to move past it.

These willful rants and rages help no one. I can let the darkness suck me up and become another casualty. Or I can turn away from the darkness toward the light. I have that choice.

I can choose to honor the light in me and my son and all those who are struggling–all the fallen children, all the mourning mothers–rather than dwelling on the darkness that dishonors us all.

I can honor the light that lies at the edge of every shadow, that pierces the storm clouds, and melts the mist. The light that filters through tree leaves, and slants across the grass, and pricks the night sky, and rains down in moonlight on the dark meadow.

I can honor the light outside my window this very moment, this first day of Spring, where the hummingbirds dazzle the garden with a bright rush of wings–hovering and humming, everywhere, everywhere! When I stop, and look, and listen.Colibri-thalassinus-001-Creative Commons photo credit mdf

Homeless, or Houseless?

800px-OIC_jindalee_sand_dunes_2 Creative Commons

Once when I was part of an effort to end homelessness in our community, one of the participants who had himself been homeless objected to the term. “We’re houseless, not homeless,” he insisted. Unfortunately his preferred term never caught on. I understood what he meant though. It was more than the fact that many people without housing live in cars or campers, or take up residence in empty buildings, or crude shacks built in remote areas.

It was the realization that all of us share a home on Mother Earth that may or may not include four walls and a roof. I remembered how Jesus once lamented that birds have nests, and squirrels have burrows, but the Son of Man has no place to lay his head. Yet we never think of Jesus as having been homeless. Nor do we think of our nomadic ancestors as having been homeless. There was always a sense that people were at “home” in their own bodies, in their natural environment, and in the communities of those they identified with.

This realization struck me on a deeper level years later when my own son suffered from long bouts of “houselessness,” living on the streets, or in cars, or in this case in the sand dunes, when he could not find nor afford a drug treatment program that could take him in– or he was too strung out to seek to recovery.  After living that way all summer and most of the fall, he contacted me. He wanted to get clean, and needed a place where it would be safer and warmer to wait for a bed to open up.

Sand_dunes_-_Oceano_CA wikipediaWe met in a parking lot and he had me drive him to the beach so he could hike back into the sand dunes to collect his gear.

I offered to go with him and help carry it back, but he said no. It was too far, and the most direct route would have us climbing up and sliding down huge dunes. So I took a walk along the beach while awaiting his return.

The weather had been stormy for the last few days and the morning sky was a molten sheen of silver as the sun tried to burst through. The tide was out and tiny rivulets of water had formed between the ripples of wet sand, reflecting the bright sky. Dozens of sand dollars in all sizes had been washed up on the beach, most of them perfectly whole, and I collected my share. Hundreds of tiny sea birds hunted among the puddles and shallow waves. Among them gulls flew in and out, and one long-legged white heron tip-toed among its cousins.

IMG_3297It was breathtakingly beautiful and peaceful. I imagined him up there, all alone among the sand dunes at night, peeking up at the bright expanse of stars, hearing the hum of the breaking waves, breathing in its salty breath.

Camping out it might have been called–once upon a time in a land far away.

But when he returned with his gear I found out it wasn’t that way at all. The dunes where he slept were full of fellow travelers. As we were driving away he had me pull over so he could hail down a man on a bicycle packed tight with tent poles and back packs and what looked to be a small camp stove.

“Tell Josh I left the tent and blankets he loaned me out there for him.”

Kelli pic 2Josh was a young man living in the dunes with his girlfriend. They had grown up “houseless” and now were living a ”houseless” life together.

Many people like them and the bike rider lived back there, and the place where he had slept would not remain empty long. The secure burrow deep beneath a sage bush had been dug by another, inhabited and abandoned time and time again.

But that’s not the half of it, he told me. Many have lived out there so long and had become so adept at doing so, they had tapped into the electric grid and had TV, computers, and electric lights.

This was true back in the canyons far from the beach as well. There a whole community of “homeless” residents lived, having dug caves and elaborate tunnels into the hillsides, and built tree houses for lookouts to guard against intruders. Hundreds lived back there, he said, in relative luxury, since they too had found ways to plug into the electric grid. The homeless 1%, I suppose.

This is not to make light of, nor to romanticize the plight of people who lack mainstream housing. There is no question that for some this is a lifestyle choice.

DCF 1.0But for the vast majority who live on the streets or in the dunes and canyons, they do so because they have no other options. They are there because poor health and medical bills left them bankrupt and houseless. They are there because a lost job, a string of bad luck, addiction, mental illness, and an array of other similar calamities left them no choice but to try to find a way to exist without a house to live in.

Sadly, we’ve make outcasts and outlaws of the poor and sick and struggling. We’ve banished them to live outside the norms of society and forced them to create counter communities at the fringes of society.

We call them homeless, when in truth we all share one home. We’ve simply failed to provide for our own. We’ve failed to create the kind of safeguards and services that would keep all of us safely housed.