Holiday Strategies for Staying Clean and Sober
People in early recovery bring all sorts of hopes and fears into the holiday season. One minute we can be excited to be part of the family again. The next minute we flood with shame about the past. We can still struggle with inner loneliness and often feel apart-from rather than a-part-of family. We try on our recovery crusader cape and get ready to recruit others in the family. Our emotions and energy levels still react like a roller coaster. We fume and defend ourselves in our minds against the family that probably only wants to talk about our mistakes and won’t give any credit for our new sobriety – at least we imagine the family wants to criticize us. Just to be prepared, we stake out a defensive position.
But really, staying clean and sober and sane through the end of 2018 has nothing to do with family or holidays. We stay clean and sober when we are willing to try and to do whatever it takes to keep our sobriety.
Suggestions don’t keep us clean; our willingness to try the suggestions is what keeps us clean.
1. Go to bed clean and sober.
No kidding, it’s the only way to put together time in recovery. Doesn’t matter if you go to bed clean and sober for the right reasons or for the wrong reasons. Does not matter if you go to bed clean and sober with the right attitude or the wrong attitude. Doesn’t matter if you go to bed clean and sober after your mother kept her opinions to herself or your mother kept asking in front of the whole world why you have such bad acne. Does not matter if you go to bed clean and sober having had a good day or the worse day of your life. No kidding. Go to bed clean and sober.
2. Go to tons of meetings
Go to tons of meetings. People whine at meetings? They tell the same stories over and over again? No one ever asks you how the meeting should be run? Doesn’t matter. Go to tons of meetings.
3. Binge on Netflix
Binge on Netfix. Seriously, we now know that humans are meant to find escape in binge tv. Otherwise, why would a major corporation be dumping 13 episodes of a series all at once on a Friday afternoon?
4. Stay away from old places and old habits and old friends.
Our disease will tell us that we’ve been clean long enough to hang out with that guy. The disease lies. We need to keep doing all the things that have helped us get and stay clean and sober AND we need to keep not doing all the things that haven’t and shouldn’t have been part of our recovery.
5. Reach out
Reach out to another person in recovery who is more alone and more fearful than you. Then the two of you together go find someone in recovery who is less alone and less fearful and just hang out, between meetings.
Watch out for the HALT times when you are hungry, angry, lonely, or tired. Dehydration can be a bitch too. If you are hungry, eat. Lonely, call people in recovery. Angry, forgive. Tired, take a nap. Thirsty, drink a glass of water. (Trolling your ex’s Instagram account didn’t make the list of suggestions.)
Don’t try to resolve your past during the high drama of holiday season. Holidays aren’t real life, which is why they are called holidays. Wait until real life days to address your dad’s lack of trust or to make promises about the future or to make apologies about the past.
Practice the WAIT question: Why Am I Talking? If you feel the need to talk, say to others, how are you?. Say please and thank you. If you’re a jerk, pretend you aren’t. That’s not a suggestion to be dishonest; it’s a suggestion to be courteous.
Prayer isn't an effort if we believe in some sort of higher power and then actually pray. But what if there is no such thing as a higher power? Why would we want to waste our time? Because in recovery we should become as willing to try prayer as we were to try a new drug. Very few of us ever turned down an offer to get high because we weren’t sure the drug was legit or because we didn’t want to waste our time snorting what might turn out to be baking soda. Be as gutsy with God as you were with drugs.
10. And finally...
And most important, go to bed clean and sober. Even when you don’t want to, or when it sucks, or when you feel alone.
Because the greatest holiday gift we can give family is the gift of time in recovery, the gift of racking up days.
Solo No More -- The Riverbank House Recovery Community Retrospect
August 30, 2018 by Jessie Brooks-Janzen, MSW (reprint, lightly edited for format)
I work with Individuals and Families impacted by Addictive Behavior. That work often entails exploring treatment options for loved ones. Finding the right recovery community or program can be difficult and overwhelming. There are many of questions and concerns. Is it worth the money? Why would I want to go there for help? Will my loved one find recovery? Inpatient or Outpatient? As a result, I carve out time in my practice to visit treatment programs. I visit both in state and out-of-state programs so I can do a preview prior to recommendation.
I recently visited Riverbank House recovery community in Laconia, NH to review their program for the Individuals and Families I work with here in Seattle, WA. Some families might ask, why would I send my loved one so far away for help? And in all honesty, I thought to myself - would I really recommend sending someone that far from home?
And in one word my answer is, "YES."
Why the Riverbank House?
Recovery community promotes recovery success.
Riverbank House consists of multiple historic homes lining two sides of a gentle river. Unlike many rehabs, this recovery community defies the stereotype of a clinical, sterile, lock down setting. Residents fully integrate into the larger community. Residents shared with me that a large part of their recovery is not only about learning how to stop addictive behaviors. These men also learn how to live life again within the community by building and practicing important skills.
Addictive behaviors thrive best when a person is solo, with no accountability and in isolation. Regular contact with environments, friends, and family would counteract addiction. Therefore, a key support that is provided for each new resident at the Riverbank House is a mentor for their duration of stay. The mentor is a more senior resident who is further along in their recovery. Their job is to partner with the more junior resident. They introduce it as the concept, "Solo, No More." Part of an individual’s recovery is learning how to live in community again. When you are in a therapeutic community with accountability and mentors, addictive behaviors cannot thrive.
Practical life skills are challenging for individuals in active withdrawal. Detoxing makes everyday tasks even more difficult. Having a safe environment with others to support and encourage you is key. Residents live in homes, typically 2 roommates to a room,. They have household responsibilities and a daily schedule to follow. Essentially, many are learning the basics on how to live life without substances. They retrain their brain, bodies, and emotional selves that substances are undermining their daily life. Routine, mentoring relationships, accountability, and time help residents build these life skill muscles that have been idle, while they were in their addictive behavior.
Emotional and Mental Health
The emotional and mental health of an individual struggling with addictive behaviors must be addressed in order to achieve recovery. An important part of the Riverbank Program is their philosophy that there are "many pathways to recovery," which encourages residents to be open to new ways of living by participating in meditation and mindfulness, process groups, yoga, 12-Step, SMART Recovery, Relapse Prevention, etc. Stopping the behavior is only one piece of recovery - understanding what, why, and how is the foundation that will help the individual sustain recovery. Therefore, these varying options provide residence an opportunity to explore what are the triggers that may lead to relapse? What tools can be used to cope with urges? Why did I engage in addictive behaviors? How can I sustain my recovery?
Vocational and Educational Pursuits
Continuing education and finding employment is something residents also work on while at the Riverbank House when they have sustained 5 months or more sobriety. This is another key aspect to a residents recovery, because for many they may have lost employment or stopped education, as their addictive behaviors encompassed them. There are many employment opportunities and experienced provided: Woodworking, Construction & Landscaping, Karma Café & Art Gallery, Yoga & Fitness Instruction, etc. There is also a Lakes Region Community College minutes away for residents who would like to continue their education, while living in a sober environment.
Recovery Is Not a Sprint; It's a Marathon
I often share with clients who are grieving the loss of a loved one that there is no timeline on grieving. I also believe this to be true when talking about recovering from Addictive Behaviors for both the Individual and their Loved Ones. 28 days, 60 days, 90 days - Recovery is a life long commitment - it is a training program for all involved. Old behaviors need to be replaced with new ones that strengthen Recovery. Skills develop over time while the body, mind, and spirit heal.
And Riverbank House "places no limit on the duration of stay." What this means is that residents are encouraged to stay longer than the initial commitment that residents make - some say, "I'll try it for 28 days," most stay beyond that initial commitment of 28 days and find that the length is key to their recovery. Effective treatment takes time, because it requires time for healing a persons whole self - mind, body, spirit. Experts and evidence-based providers are finding that long term care and continued care promotes long term recovery.
Please feel free to reach out to me if you have questions about my experience at Riverbank House or are in need of Individual or Family Counseling. 1417 NW 54th Street #462 Seattle, WA. 98107 | 206-905-9931| email@example.com
The complete article.
Karen Franklin of Family Intervention & Recovery Services
Riverbank House recently sat down with Karen. We spoke about the help available to families through addiction intervention.
RBH: Many families don’t know about interventions or about working with a professional interventionist. Why and when would a family want to speak with a professional? And what does that relationship look like going forward?
KF: It is common that those who struggle with addiction are in denial about their situation. Thus, they are often unwilling to seek treatment. As shocking as it may seem, they may not recognize the negative effects their behavior has on themselves and others.
Intervention helps the person make the connection between their use of alcohol and drugs and the problems in their life. The goal of intervention is to present the alcohol or drug user with a structured opportunity to accept help and to make changes before things get even worse.
Our work with the family begins with the Intervention.
We provide case management, after-care planning and family support and consultation for up to one year after the Intervention. We walk along side our families and support them through the first year of recovery.
RBH: Does an intervention ever “fail”? And if it does fail, is the family now more faced with more hurt than before the intervention? Is there a risk to intervention?
KF: In my opinion, there are no failed interventions. Our experience is that most people do accept help and go to treatment the day of the intervention. However, there are those that refuse help on the day of the intervention. The one thing we cannot control is that the addicted person has free will and choice. Frequently, most who refuse end up accepting help usually within a short time if the family holds boundaries and no longer enables the addicted person.
Families Become Stronger
In our experience, families become more united in supporting the addicted individual in making healthy decisions. When this change happens, families no longer support a loved one in making the unhealthy decisions. Families begin to understand how the addiction has taken over their lives. When this understanding occurs, they begin to take their lives back and get their own help. As Al-Anon literature states: “Changed Attitudes can Aid Recovery”
RBH: When you make a recommendation to a family, what determines the fit between a client and a recovery program or rehab?
KF: Family Intervention and Recovery Services does a full assessment with the client and family to determine treatment options. We consider all factors in the case such as age, addiction or mental health history, co-occurring disorders, trauma, prior treatment experience, financial issues. The factors help us determine the best course of treatment for each individual case.
The Importance of Long-term Recovery Support
For young adults, we strongly recommend long term options such as a recovery program like Riverbank House. Those struggling with opioids also need a longer-term option to have enough time to stabilize in their recovery. Those that have had multiple, unsuccessful rehab experiences and chronic relapse issues are those we also highly recommend for a longer-term recovery program.
Men who have struggled with addiction and have not been able to attain success with school or career are also excellent candidates for your program. Also, someone coming out of a primary treatment program would be a great candidate for Riverbank House as an extended care option.
I tell families that a 28-day or 30-day rehab experience does not offer a lasting solution. Unfortunately, the expectation that a short-term stay is effective can set up a cycle of chronic relapse. This cycle often involves visits to countless treatment centers.
Recovery is a journey and it takes time to get better. A primary short-term rehab is just the beginning. They didn’t get sick overnight and they are not going to get better overnight either. They need continued structure and support to succeed.
RBH: Thank you Karen. You've been a terrific friend to Riverbank House and we much appreciate your willingness to share your wisdom with us.
Karen is a native of New England, currently living in Phoenix, AZ. She is a road warrior working with families nationwide in her Intervention Practice.
Karen can be contacted at 602-690-8440 or via email at firstname.lastname@example.org.
How Addiction Affects Parents
When a son or daughter struggles with addiction, parents become secondary victims of the unprecedented opioid epidemic that kills 90 Americans each day. The experience of parenting through addiction can be devastating to the powerless parent, to a marriage, to the family as a whole. The downloadable resource guide "Waiting Between: When a Son or Daughter Struggles with Addiction" is an attempt to give the experience a name. The booklet also hopes to encourage parents that they are not alone or crazy or ineffective.
A Particular Type of Grief
Parents of adult children struggling with addiction to drugs or alcohol share in a universal state of suspended grief. Hope can become the enemy. Defeat can feel like a parental betrayal. The booklet explores the theory of ambiguous loss, developed by Dr. Pauline Boss at the University of Minnesota. Dr. Boss' work has been applied to families coping with Alzheimer's or dementia, or to families with MIA service members, or to families with a member who is missing under explainable circumstances. But it is a perfect fit explanation for the experience of parenting a son or daughter who struggles with addiction. And as parents, we could use all the explanation we can grab to sustain us through the emotional marathon of a child's drug or alcohol use disorder.
Riverbank's Pat Anderson Recognized for Work in Recovery by the Police Assisted Addiction Recovery Initiative
On June 28, PAARI honored the law enforcement partners, public health leaders, and elected officials who have helped grow its mission nationwide. PAARI encourages opioid drug users to seek recovery, distributes life saving opioid blocking drugs to prevent and treat overdoses, connects addicts with treatment programs and facilities, and provides resources to other police departments and communities that want to do more to fight the opioid addiction epidemic.
More than 200 people, including Richard Baum, acting director of the White House Office of National Drug Control Policy, law enforcement from around the country, state officials, and public health advocates attended the event marking the two year anniversary of PAARI, a drug addiction treatment program that grew out of the Gloucester Police Department’s Angel Initiative.
Pat Anderson was one of four past participants in the Angel program saluted at the ceremony. They were each awarded the Stephanie Jesi Memorial Scholarship to help them on their paths toward recovery. The Scholarship is named for the Middeton, MA woman who went through a PAARI opioid treatment program, but relapsed and fatally overdosed in December 2015.
Excerpts from Pat's acceptance speech:
I want to start by saying that I should not be standing in front of you today. I had accepted that I would die alone with a needle in my arm. I made sure that nothing was going to get in the way of my addiction. Not the love of my family, the love of a woman, not the police, not a job, not anyone or anything. I was wasting away and would wake up every day upset that I’d woken up at all, having lost my will to live. I was in the vicious cycle of addiction, frequenting detoxes, rehab’s, and sober houses. I would put together some clean time and begin to put my life back together only to relapse and have it come crashing down around me again. I was trying anything and everything outside of actually working on myself and trying to change my ways.
Thankfully, with help, I was finally able to break that vicious cycle. (The Angel Initiative) is where my journey began. I was fortunate enough to enter the Riverbank House recovery community in Laconia, NH after the initial help I received from the Angel program. I am still at the Riverbank House today where, after 6 months, I was given the opportunity to help other men suffering with addiction. I have a purpose today and I wake up grateful to be alive.
We cannot fight this disease alone. We need help and support from our loved ones and especially from our communities at large. We need to remember that an addict is still someone’s son, brother, cousin, daughter, wife, husband, friend, co-worker. There are so many people in our communities suffering in silence. They need to know that help is available to them and that there is a way out other than death. I will continue to fight for myself and fellow addicts and to honor those that didn’t make it. Thank you everyone for the opportunity to speak to you tonight. It is truly an honor. God bless.
The entire Riverbank House recovery community is proud of you Pat!
Addiction took everything from me but bones and a beating heart.
The disease sucked in every good thing in my life and spat it out. What's worse, I couldn't even recognize the good when I had it.
I lost my dad when I was 11, and I looked for something or someone to blame. I blamed the world. "What kind of cruel life is this if everything you love will eventually be taken from you? Why should I even try?"
Before grief broke me, there was a time I was a happy boy with hopes and dreams. I wanted to be a super hero and save people from harm. I wanted to inspire hope and joy. What ever happened to that boy?
I can't describe the hopelessness I carried, and then used as an excuse. Trying to avoid pain, my entire life became an attempt to destroy myself.
I used drugs to fix my feelings instead of trying to fix them myself. I thought I had something wrong with me that could never be changed. Drugs took away all the self-doubt, fear, and sadness. When I was high, I felt like I had control over myself and the cruelty of life.
My reckless escape from reality set me up to make one poor decision after another while never getting me any closer to the peace I so desired. I’d set up an endless cycle of doing drugs and making bad choices and then doing drugs to forget those bad choices.
I lied, I cheated, I stole, and I hurt. A lot. It's funny how what we believed was the solution was really the problem.
A failed suicide attempt and a couple overdoses later, I ended up at the Riverbank House.
I thought my life was over. I had barely been able to stay alive while high; how could I now face life and the mistakes I’d made without the protection of drugs?
But Riverbank helped me find what I had lost: the will to live. And with that, redemption.
My whole life I had been avoiding pain at all costs. The staff at Riverbank House suggested a different approach; face it. Face the pain with the support of men who understand. Talk about the pain. To my disbelief, slowly but surely, I stopped hurting so much. And the more I stopped hurting, the more I started living, clean.
Today, I'm training to earn my Certified Recovery Support Worker license. I'm working at and contributing to the amazing transformations that go on here at the Riverbank House, working with men who were as hopeless and helpless as I once was. I still may not have acquired the super powers I’d dreamed of as a little kid, but I do have the one gift shared by all men in active recovery: the gift of Understanding. All the hardship we may have suffered in active addiction, all the reckless mistakes we made, and all the cruel pain we caused have been turned into a tool for helping each other, for extending our hand to the guy who still thinks his life is over or not worth living.
I’ve been clean for 9 months, and today my mom has her son back. My brother and sisters have their brother back. I came into Riverbank House a fractured man who could only hope to serve as an example of what not to be. Now, I'm a clean and sober man who chooses to do the right thing, not because I’m forced to, but because I want to be the best version of myself possible. For me and for the ones I care about.
To all my fellows struggling with active addiction and alcoholism: You CAN be the man you always wanted to be. There is redemption in the light of recovery. You just have to stop staring into the lonely darkness long enough to catch a glimpse of illuminated hope.
As a kid I was always smiling, always active with my friends. In high school, I didn’t even notice when sports were replaced by partying. Same friends, same fun. I went to college and partied my way right into dropping out.
When I was 21 I had surgery and ended up with a huge surplus of prescription opioids. I used them at night, just for fun, and when they ran out I bought pills on the street. I wasn’t addicted: I was a recreational user. Then I came down with a terrible case of the flu. A friend had to tell me that my “flu” could be cured by my dealer.
Opioid withdrawal was terrifying. I took a hard look at that and decided it would be a good idea to switch from pills to heroin because it was cheaper and more available.
When heroin became a problem, I thought it would be a good idea to switch to Suboxone. Turns out they don’t just hand out scripts for Suboxone. I decided I would try to fit detox in over the weekend.
In detox, they wanted me to go to a 28-day program, but my insurance was limited. All the “good” rehabs were going to cost $20,000. My mom found Riverbank House online. Twenty-eight days in Riverbank House cost about the same as the out-of-pocket deductible I would have paid if I’d found a place in Massachusetts that would take my HMO.
Randy explained upfront that he really believes in long-term care of at least 90 days, but that’s just crazy. I came for the 28.
Riverbank was nothing like the rehabs I had imagined. It wasn’t a hospital or an institution. The doors weren’t locked. Every morning we walked downtown to a 12-step meeting. The Riverbank guys were so relaxed, so funny, so bonded by a common goal. It sounds like such a cliché to say it’s a true brotherhood, but there’s no other word that’s as accurate. I wanted to spend 28 days here. They taught us how to support each other and hold each other accountable. They taught us that every first thought is probably wrong. Most importantly, they taught us that real life can be awesome without drugs and alcohol, and then they proved it. Riverbank House kept me so busy, so active, so supported that I was completely distracted from any thoughts of using.
Then a funny thing happened. I was on the phone with my mom when I realized I was at day 28. No one at Riverbank House had asked me to leave and no one had pressured me to stay. I was in a position to choose; I could leave at any time. I decided to stay.
I practiced doubting every first thought. My fight or flight reaction calmed way down. I started to really appreciate life. My head stopped racing in circles. The staff taught me the path of right living and then let me put it into practice for myself.
But everyone has to go back home sometime, right?
“Don’t worry about that now,” the guys said.
Seven months ago I was a totally miserable 31-year-old opioid-addicted pizza delivery boy without a smile, living at home with mom, thinking it would be easier to die than to get clean.
Today, I’m an advocate at Riverbank House, working with the newest guys. I live right in the middle of the brotherhood and I’m about to start recovery coach certification training. I trust today. I contribute. I’m having more fun than I ever thought possible. I have my smile back. I have a future. I am truly free.
Ever wonder how to make BIG MONEY from the opioid epidemic? Large financial firms have discovered that investments in suffering offer reward over risk. One example firm --Deerfield Management -- shows how it’s done, if you can follow the money*
Invest in Addiction Recovery Care
$100M: Deerfield’s additional and potential stake in AAC , consisting of “$25 million of convertible debt and $25 million of subordinate debt.” According to its own website, “Deerfield also agreed to provide an additional $50 million of convertible debt upon certain circumstances.”
$231.5M: Deefield's investment in Recovery Centers of America (RCA) for what Deerfield describes as the “development or purchase of eight treatment campuses located along the Northeast Corridor that will provide a comprehensive continuum of integrated care.” RCA isn’t a publicly traded company. Its first McRehab opened in March.
Both AAC and RCA accept most major insurances.
Invest in The Major Insurers That Cover Addiction Rehab
Invest in Psych Care and Psych Meds
Recovery Centers of America pledges to “address all level of substance use disorders and dually diagnosed patients.” American Addiction Centers boasts a dedication to the Dual Diagnosis and treatment of anxiety, depression, bipolar, trauma in conjunction with the treatment of addiction.
Deerfield complements its investment in addiction and dual diagnosis treatment at RCA and AAC with stakes in:
$9.5M: Zafgen, Inc., a company that develops novel obesity therapeutics. (The AAC chain of rehabs includes a facility specifically for treatment of binge eating disorders.)
$5.1M: Alcobra Ltd, a company finding new ways to treat ADHD.
$688k: Endo, another huge pharmaceutical company whose subsidiary manufacturers generics versions of many drugs used to treat anxiety (29 forms of Klonpin, 12 of Xanax, 18 of Valium, 9 forms of Ativan, 6 forms of temazepam,), panic disorders, ADHD, and sleep disorders. Endo's medications include popular antidepressants, anti-pscyhotics, and mood stabilizers.
$35M: Titan Pharmaceuticals . According to Deerfield, Titan produces “an approved product for schizophrenia called Fanapt®/(iloperidone)” and “an ongoing phase III program for probuphine in opioid addiction, which represents a significant upside opportunity if successful. In exchange for our $20 million, we received a note, warrants and a 2.5% royalty on the net global sales of Fanapt. In late 2011, we restructured this transaction by purchasing the remaining 5.5% Fanapt royalty that was owned by Titan in exchange for $10 million in debt and an additional $5 million in cash.”
Invest in the Opioids that Cause Addiction
Deerfield’s $688k stake in Endo goes a long way in casting a wide net over potential profits from addiction. Sued by the state of California for its part in the opioid epidemic, Endo is alleged to have “deceived physicians and patients alike by exaggerating the effectiveness of opioids for the treatment of long-term, non-cancer pain and withholding information regarding the dangerous, addictive effects of the drugs.”
ADDICTION, ABUSE, and MISUSE; LIFE-THREATENING RESPIRATORY DEPRESSION; ACCIDENTAL EXPOSURE; and NEONATAL OPIOID WITHDRAWAL SYNDROME; and INTERACTION WITH ALCOHOL
Endo’s generic opioids include 13 forms of Percocet, 10 of fentanyl, 32 of hyrdrocodone, 3 of Demerol, 11 of morphine sulfate (versions of MS Contin), 4 of oxycontin, 8 of roxicodone, 2 of Opana, 4 cough syrups with codeine, and 8 forms of tramadol.
$375M: DepoMed, Inc, “a specialty pharmaceutical company focused on developing and commercializing products to treat pain.” Its flagship product, NUCYNTA, purchased from Janssen Pharmaceuticals (see sued by California above) for $1.05 billion, carries this warning:
NUCYNTA® ER contains tapentadol, an opioid agonist and a Schedule II controlled substance that can be abused in a manner similar to other opioid agonists, legal or illicit. There is a greater risk for overdose and death due to the larger amount of tapentadol present in NUCYNTA® ER. Assess risk for opioid abuse or addiction prior to prescribing NUCYNTA® ER. Addiction can occur in patients appropriately prescribed NUCYNTA® ER at recommended doses; in those who obtain the drug illicitly; and if the drug is misused or abused.
$28M: Lannet, another manufacturer of generic opioids including oxycodone, morphine sulfate, and hyrdromorphone.
$1.3M: Eaglet Corp, whose slogan is “delivering pain relief with peace of mind.” Eaglet offers only two products, one of which is Oxaydo, “the FIRST and ONLY immediate release oxycodone that discourages intranasal abuse.” According to Eaglet, “There is no evidence that OXAYDO® has reduced abuse liability compared to immediate-release oxycodone.” In other words, Oxaydo is addictive? The company goes on to warn that:
OXAYDO contains oxycodone HCl, an opioid agonist and a Schedule II controlled substance. Such drugs are sought by drug abusers and people with addiction disorders. OXAYDO can be abused in a manner similar to other opioid agonists, legal or illicit ... OXAYDO may be abused by crushing, chewing, snorting or injecting the product and these practices pose a significant risk to the abuser that could result in overdose and death.
If you or someone you love develops an addiction to Oxaydo, Nucynta, Belbuca, Opana, Percocet, or a generic opioid, Deerfield can recommend an addiction treatment facility.
Invest in the Pharmacies that Sell the Drugs
If you or someone you love has a prescription for the opioids or benzos or psych meds in which Deerfield invests, you can fill those prescriptions at Rite Aid ($20M investment) or Walgreens ($50M).
Don't live near a major pharmacy chain? No problem. Deerfield is working to bring the pharmacy to you with its investments in:
$15M: Wellfount, which, according to Deerfield “provides long term care pharmacy services through a safe, cost effective approach that combines technologically sophisticated remote dispensing units with high touch, on-site customer service."
$5M: MedAvail, which, according to Deerfield, “is a healthcare technology company that has developed a self-service kiosk that supports the dispensing of prescription and over-the-counter medications in locations where it is impractical to build a full pharmacy or where additional pharmacy capacity or hours of operation are needed.”
Invest in Drug Delivery
$4.5M: Steadymed, Ltd , which provides devices for delivery of pain management (pumps). According to Deerfield, “ The global pain management therapeutics market has huge potential for growth due to the large population that is affected by medically significant pain.”
Invest in Technology to Keep Opioids Marketable
“Abuse deterrent technology” typically consists of coatings or polymers applied to existing extended release opioid formulas to prevent the crushing or chewing that can lead to avenues of abuse. Deerfield is a big believer in such technology. Its abuse deterrent investments include:
$1.7M: Acura Pharmaceuticals’s AVERSION Technology was applied to oxycodone and viola! you get Oxaydo by Eaglet ($1.3M investment by Deerfield), which Deerfield points out is “the first and only approved immediate-release oxycodone product in the United States with abuse deterrent labeling.” (See Oxaydo's black box warning above.)
$7M: Kempharm, Inc. stock. Kempharm, according to Deerfield, is a “ biopharmaceutical company focused on the discovery and development of new chemical entities (NCEs) for the treatment of pain, ADHD and other CNS diseases.”
$60M: financing for Kempharm research and development. According to Deerfield, financing it provides “in the form of convertible and term debt, will enable KemPharm to progress its lead abuse resistant opioid analgesic, KP201, through regulatory approval and onto the market.”
$3.2M: Neos Therapeutics stock. According to Neos, its abuse deterrent technology was developed in response to the “63.1 million prescriptions for medications with ADHD labeling, principally in extended-release formulations, written in the United States” in 2014 alone.
$20.6M: Neos Therapeutics financing that, according to Deerfield, will “support the company’s efforts to obtain approval for its methylphenidate XR-ODT as well as two additional ADHD drug candidates, an Amphetamine XR-ODT and an Amphetamine SR-Liquid Suspension.”
$31M: Research and Development financing for Flamel, which develops abuse-resistant modified/controlled release narcotics/opioid analgesics for a U.S. opioid drugs market that, according to Flamel, surpassed $4.6 billion in 2014.
Cover All Bases
$30M: Discovery Labs, which is, according to Deerfield, “a specialty biotechnology company focused on advancing a new standard in respiratory critical care.” Respiratory critical care is often necessary when black box warning about respiratory depression or the abuse deterrent technology aren’t enough to protect opioid users from life threatening respiratory distress due to opioid overdose.
$83M: GW Pharmaceuticals, whose vision is to be “the global leaders in prescription cannabinoid medicines, through the rapid cost-effective development of pharmaceutical products which address clear unmet needs...”
Opioid Addiction Investments 101
There you have it: an outline of how just one of many financial investment firms is finding big money, legally, in most every aspect of drug addiction.
* Values as reported by Nasdaq and Deerfield August 23, 2016
Reprinted with permission from whenweloveanaddict.com.
RCA Hopes to One Day Create Neighborhoods Much Like Riverbank House Drug Rehab in New Hampshire
Recovery Centers of America, the up and coming chain of commercial addiction treatment facilities backed by the Big Pharma investors at Deerfield Management and headed up by a real estate developer and former pharmaceutical executive, is hoping to establish recovery neighborhoods much like the model practiced for years by Riverbank House in New Hampshire.
RCA's vision for the future includes the hope that "RCA Recovery Campuses will become centers of recovery communities in the cities and towns they serve. RCA will host and support 12 Steps and other group meetings for all members of the local recovery community in well-appointed, safe and comfortable meeting rooms."
What the Experts Say about Recovery Neighborhood Approach
Whatever your reaction to commercial treatment centers backed by venture capitalists who have one foot in Big Pharma and another in addiction care, the recovery neighborhood model that RCA hopes to one day adopt is a concept backed by experts in the field of addiction science.
SAMHSA's "Four Major Dimensions that Support a Life in Recovery" -- Health, Home, Purpose, and Community -- are central components to the Recovery Neighborhood model.
The Recovery Research Institute of MGH and Harvard Medical School is even more direct, stating:
Recovery communities and support services are a critical component of ongoing care for people in recovery.
One Drug Rehab in New Hampshire Pioneers the Model
Riverbank House in New Hampshire is a drug and alcohol residential program that promotes the long-term care model endorsed by experts in the field of addiction science. Riverbank House believes that an acute care institutional model that confines the patient during addiction treatment does not prepare the person for a real life in recovery. The Riverbank House recovery neighborhood in New Hampshire constitutes an actual small city neighborhood, providing experiential, hands-on, real world practice in the daily maintenance of addiction recovery. RBH men in recovery can live and thrive drug-free in the neighborhood for as long as it takes them to reach their personal, social, educational, and vocational goals.
When asked if Riverbank House hosts and supports 12 Step groups, the neighborhood residents seemed taken aback. "We practice the 12 steps and we are proud of our membership in 12 Step groups," one man said as his friends nodded in agreement. "But we've been taught to respect the 12 Traditions as well as the 12 Steps." He turned to his friends before asking, "How could Riverbank House host and support any 12 Step group and still abide by those Traditions?"
The neighborhood resident, one presumes, is referring to Traditions 6 and 7, which suggest that every AA group refrains from affiliation with outside enterprises and that each group remains self-supporting.
Long-term addiction care in safe recovery communities encourages such questions -- by giving men the gift of time necessary to truly own their recovery community membership.
Republished from www.whenweloveanaddict.com. Copyright 2016.
Huffington Post Pulitzer nominated eight chapter expose "Dying To Be Free" by Jason Cherkis. Print
- There’s A Treatment For Heroin Addiction That Actually Works.Why Aren’t We Using It?
The Washington Post Cheap Fix: Heroin's Resurgence: "And Then He Decided Not to Be" by Marc Fisher. Print
- David McCarthy briefly got clean on his own after detox programs and rehab failed. But the lure of inexpensive, plentiful heroin eventually proved too much.
Los Angeles Times: "A TIMES INVESTIGATION" by Harriet Ryan, Lisa Girion, and Scott Glover. Print
- ‘YOU WANT A DESCRIPTION OF HELL?’ OXYCONTIN’S 12-HOUR PROBLEM
The Washington Post: Health and Science expose: "After their children died of overdoses, their families chose to tell the truth." by Alexandra Rockey Fleming. Print
The Washington Post: "How's Amanda?" by Eli Saslow. Print
- 'Reality's a trigger': An excruiating story of truth, lies and an American addiction.
National Health Coverage Journal
STAT, an online journal reporting from the frontiers of science and health. David Armstrong's Special Report: "Dope Sick." Print
- A harrowing story of best friends, addiction — and a stealth killer.
HBO "Addiction Project," produced in partnership with the Robert Wood Johnson Foundation, the National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Video and print.
CBS News: In Depth "America's Opioid Epidemic." Print and video
- Inside America's growing struggle with opioid painkillers and heroin addiction
NBC News: "America's Heroin Epidemic." Print and video
- A searing, two-hour investigation places America’s heroin crisis in a fresh and provocative light -- telling the stories of individual addicts, but also illuminating the epidemic's years-in-the-making social context, deeply examining shifts in U.S. drug policy, and exploring what happens when addiction is treated like a public health issue, not a crime.
NPR 4-part series "Treating the Tiniest Opioid Patients," Audio
NHPR "Dangerous Ends: New Hampshire's Opioid Crisis." Print and Audio
WBUR, Boston's NPR News Station: "America's Opioid Epidemic and the Shifting Response" and "Opioid Addiction Crisis." Print and audio.
MPRNews "Minnesota's Opioid Epidemic." Print and audio
- Stories of addiction, loss and recovery from a public health crisis: Deaths from opioid drug overdoses have hit epidemic proportions nationwide and across Minnesota.
Non Profit Publications
HealthCommentary: Exploring Human Potential. "Man-made Opioid Epidemic: A Five Part Series." Open Source for Educators. Print
Kentucky Educational Television "Inside Opioid Addiction." Print
Trend CT, a data reporting online publication of the non-profit, non-partisan Connecticut News Project, Inc. "Five Part Series: Why Connecticut's Drug Overdose Crisis Isn't Slowing Down." Print
Pittsburgh Post-Gazette "Overdosed: How Doctors Wrote the Script for an Epidemic" by Rich Lord, J. Brady McCollough and Adam Smeltz. Print
The Gloucester Times. "The Heroin Crisis" tells the often uplifting and often discouraging story of ground-breaking efforts by Police Chief Leonard Campanello in Gloucester, Massachusetts. Print
The Gazette, Cedar Rapids, Iowa. A series in six chapters, "Heroin's Hold" by Chelsea Keenan. Print
- How Iowans struggle - and sometimes succeed - in overcoming opioid addiction
- A Raw Inside Look at the Heroin and Opioid Epidemic
Opioid Dependence and Opioid Addiction
In the context of drug treatment, we seem to understand that you can be opioid dependent without being opioid addicted (in, say, the case of a terminally ill cancer patient).
We seem to understand that opioid dependence and opioid addiction are directly linked.
But sometimes we forget – with the encouragement of insurance companies – that opioid addiction is still very much a problem even if we are no longer opioid dependent.
The person who is no longer opioid dependent -- as a result of successful detox – is still very much opioid addicted.
The journal Addiction Science and Clinical Practice defines dependence as the need to keep taking drugs to avoid the physical discomforts of withdrawal.
The journal defines addiction as abnormalities in the brain caused by past drug use that provoke intense craving and compulsive use; both the cravings and the compulsion to use can still be triggered -- even after successful detox -- by environmental triggers such as stress, old memories of pleasure, and psychological conditioning. The brain abnormalities that define addiction "can produce craving that leads to relapse months or years after the individual is no longer opioid dependent."
While both dependence and addiction are the result of abnormal changes in the brain caused by chronic opioid misuse, the symptoms of opioid dependence clear up within a few weeks of detox. The neurobiological impairments of opioid addiction are long-lasting and wide-ranging.
Prescribing the Right Course of Treatment
Opioid dependence can be successfully treated by short-term or acute care.
It’s the opioid addiction that requires long-term drug rehab and extended recovery care.
Experts in every realm of addiction science – medical, academic, and governmental – unanimously agree that recovery from drug addiction requires 90 days or more of residential, long-term recovery care. The brain requires 90 days or more to heal, to resolve the abnormalities caused by drug use, to learn to cope with the stress of everyday life and to withstand the cravings triggered by factors outside of the recovering person. The healing of addiction goes on long after the healing of dependence.
Based on standards of care established by health insurance providers, people addicted to opioids are prescribed a course of treatment suitable to the treatment of opioid dependence.
This is like going to the doctor with an ax in your skull and being offered an aspirin because your head hurts.
Until diagnosis and dose of treatment become aligned with both opioid dependence and opioid addiction, we will continue to hear about the remitting, relapsing nature of this chronic, life-long brain disease.
Successful Drug Addiction Treatment takes 90 days or more
A great article published in PsychCentral a few years ago outlines the benefits of long-term drug treatment by asking "How Long Is ‘Long-Term’ Drug Rehab?" The article, written by David Sack, MD, is a near-prophecy for the comprehensive program developed by Riverbank House in Laconia, NH. Here are excerpts:
There is a growing consensus that for those who can manage it, long-term addiction treatment is the most effective option. Thirty days of residential treatment used to be the generally accepted standard in treatment. Why 30? Not because research showed its effectiveness, but because that was the average length of stay covered by insurance. Now, the National Institute of Drug Abuse has declared 90 days of treatment the 'gold standard.'
Dr. Sack goes on to explain that "research shows that people completing at least 90 days of treatment have significantly lower relapse rates than those who stay for shorter amounts of time."
Specific Benefits of Long-Term Recovery Care
The Four Guiding Principles of Riverbank House:
- Effective Addiction Treatment Requires Long-Term Care
- Responsible Recovery Care Addresses the Brain Impairments that Can Hinder Success
- Responsible Addiction Treatment Promotes Many Pathways to Recovery
- Successful Recovery Requires Practice within a Safe Community
Like Riverbank House, Dr. Sack promotes long-term care because, he notes -- the brain needs time to heal, clients need time to practice practical application of new skills, new habits need time to take root, and relapse plans need to be lived with real-world exposure.
Sack, D. (2012). How Long Is ‘Long-Term’ Drug Rehab?. Psych Central. Retrieved on August 1, 2016, from http://blogs.psychcentral.com/addiction-recovery/2012/05/long-term-drug-rehab/
republished with permission from www.whenweloveanaddict.com. Copyright 2016.
Before Riverbank House, merely existing as an active alcoholic felt like a 24/7 job. Real employment or working towards any kind of a future interfered with my drinking. I lied, I cheated, I manipulated, and I stole, mainly from my parents and those closest to me. I felt worthless, hopeless and alone. Addiction destroyed every healthy relationship I had ever developed and burned almost every bridge between me and the future my parents had dreamed for me. My parents raised a musically talented extrovert with people skills and a sense of humor, but then addiction turned me into a hopeless drunk whose only concern was more alcohol. In the process, I hurt everyone around me.visualcage
By the end of each day I would go to sleep hoping that I wouldn’t wake up.
Today, thanks to the spiritual program I’ve developed at the Riverbank House, I’ve sustained over a year and a half of continuous sobriety. I wake up every day to the passionate life of self-improvement and growth and purpose. I have countless friends. My sense of humor has returned, and my fear and anxiety for the future has been transformed into optimism and curiosity.
Riverbank House feels like home. The staff never gives up. Whenever I’ve needed to talk, someone with experience and encouragement has always been available and equipped with appropriate suggestions and insight to tackle any crisis I’ve faced. The Riverbank community supports me — wherever I am in my recovery, and I will always cherish that example of love and compassion.
Today, the relationships lost as a result of my drinking have been repaired. The bond with my family is strong and healthy. My friendships have worth. I’ve fulfilled a dream I had prior to my addiction: editing and writing the music for a feature length documentary film.
And I give back today. I work full time at Riverbank House, helping other alcoholics and drug addicts one day at a time with the same compassion and encouragement that was extended to me as a resident.
Strength of community at Riverbank House is arguably one of the largest contributing factors to my success. I’ve been shown and invited into a brotherhood that lets me be part of something greater than myself. I’ve seen the alternative to alone and apart. In brotherhood, I’ve been taught what it means to belong.
Addiction Recovery's 1st Step
When chronic drug users and alcoholics separate from an addictive substance they often need help coping with withdrawal. Detox is a popular umbrella term in the lingo of addiction recovery services, but new terms are emerging. The Substance Abuse and Mental Health Services Administration defines crisis stabilization as
a direct service that assists with deescalating the severity of a person’s level of distress and/or need for urgent care associated with a substance use disorder.
Addiction recovery vocabulary can be confusing. Any time an alcoholic or drug addict (especially an opiate addict) slowly or abruptly stops using – whether voluntarily or due to circumstances – the addict will experience some form of withdrawal. When a person addicted to drugs or alcohol seeks recovery services for the symptoms of withdrawal, the process is called detox or crisis stabilization or medically managed withdrawal. So the services that fall under the umbrella term "detox" always involve withdrawal but withdrawal doesn’t always involve "detox".
What Detox Is And What It Isn't
According to the federal Department of Health and Human Services, important key characteristics of successful detox and crisis stabilization are:
- Detoxification in and of itself does not constitute complete substance abuse treatment.
- The detoxification process consists of three essential components: evaluation, stabilization, and fostering patient readiness for and entry into treatment.
- Detoxification can take place in a wide variety of settings and at a number of levels of intensity within these settings; placement needs to be appropriate to the patient’s needs.
- A successful detoxification process can be measured in part by whether an individual enters and remains in some form of substance abuse treatment after detoxification.
Drug or alcohol detox and crisis stabilization are good places to start the road to recovery from addiction, but it’s crucial that we understand they are only the beginning. Because drug addiction and alcoholism are chronic, life threatening diseases that require life-long management, recovery is a marathon rather than a sprint. And as a beginning to that marathon, prescription drug or alcohol or opiate detox is the part where a marathon runner puts on the sneakers.
Addiction Science Experts Agree
The Center on Addiction and Substance Abuse at Columbia University:
Detoxification is an important step in the recovery process, but it is not treatment for the disease....Drug and alcohol detox is only as effective as its follow-up care.
Medical detoxification is only the first stage of addiction treatment and by itself does little to change long-term drug use....It is important to know that detoxification is not treatment; it is a first step that can prepare a person for treatment.
Detox alone with no follow-up is not treatment. Treating withdrawal is not the same as treating addiction.
Successful recovery from addiction requires a continuum of care. Addiction treatment takes time. And sustained recovery from addiction or alcoholism requires a lifetime of maintenance, commitment, and vigilance.
Dead is Dead
When you walk into a drug rehab in Laconia, New Hampshire, there’s a bulletin board posted with activity schedules, inspiring quotes about recovery, and facts about drug addiction. Beneath the bulletin board there’s a shrine of sorts, remembrances for a former resident who left addiction treatment and died of a heroin overdose. The love expressed by the shrine – the painted rocks and personal notes – is real but inconsequential. Dead is dead, and loving memories don’t change that dead-ness.
Opioids – prescription narcotics and illegal street drugs – are killing young people across New England in what government, news, and health organizations now call an epidemic.
Why are so many opiate users dying, and why are all users at risk of dying?
Opioids -- heroin, morphine, tramadol, oxycodone, methadone, suboxone, and fentanyl, to name a few – act on the parts of the brain that regulate respiration. In other words, they slow or stop breathing. Most overdoses lead to death because the user simply stops breathing.
Opioid Overdose Death: The Risk Factors
The first risk factor that contributes to drug overdose death is drug use. It’s that simple.
The second risk factor leading to drug overdose death is the chemical composition of the “product.” The illegal drug trade markets heroin that is 90, 80, 70 percent pure. Which means the illegal drug trade markets heroin that is 10, 20, or 30 percent something else. No intravenous drug user really knows what’s actually in the heroin, and when that 10, 20, or 30 percent of something involves a powerful additive such as fentanyl, the respiratory depressant effects of the product can increase dramatically. The initial “high” is a little (or a lot) more exquisite, the inevitable “nodding” comes on more quickly, breathing becomes slower, shallower, and then the breath stops altogether.
The third risk factor leading to drug overdose death is mixing narcotics with alcohol and other drugs such as benzodiazepines (Valium, Xanax, Ativan are a few). Alcohol and benzos aren't a narcotic, but they are central nervous system depressant and they also contribute to a decrease in respiration. When one respiratory depressant is combined with another respiratory depressant, breathing becomes dangerously slow, until, too frequently, it stops altogether.
Tragically, the fourth risk factor leading to drug overdose death is time spent in drug addiction treatment, detoxification, jail, or a voluntary or involuntary period of prolonged withdrawal from opioids. When a drug user stops using, for any reason, within days drug tolerance drops. When an addict returns to drug use – particularly heroin – the amount of product he or she could tolerate in the past has suddenly become a lethal dose.
The fifth risk factor that makes an opiate overdose more likely is using alone. When respiration becomes dangerously slow, if the user is alone, no one can intervene; no one is watching as lips turn blue, as the cigarette caught between fingers burns down to the bone. Relapse often involves shame and secrecy, causing addicts to use alone at the very time their tolerance for the drug has diminished during a period of abstinence, thus dramatically increasing the risk of overdose.
The sixth risk factor contributing to drug overdose is the overall health of the user. A compromised liver, weight loss due to malnutrition, and respiratory illnesses leave users particularly vulnerable to tolerance levels and opiates' action upon the central nervous system.
Think of every needle as a gun, and every plunge of that needle as a game of Russian Roulette. But these days, too many young people are playing the game with six bullets in the chamber instead of one. The odds favor no one.
WHEN CHRONIC SUBSTANCE ABUSE ROBS US OF THE CHILD WE ONCE KNEW
Parents of drug addicts can feel caught in a nightmare with too probable an ending. Experts tell us that drug addiction is a chronic disease that will require life-long management and that relapse is common. They tell us a drug addict doesn’t have to want help for drug rehab or addiction treatment to be effective, but no one talks much about the flipside of that equation: parents can desperately want help for an addict but that doesn’t mean drug addiction treatment will be effective for their child.
The theory of ambiguous loss -- unresolvable grief over the loss of the child we once knew, while that child is still living -- offers a helpful framework for understanding what parents face while they wait for an addict’s desire for drug treatment and the effectiveness of that drug treatment to coalesce. The site, AmbiguousLoss.com explains that when parents struggle to cope with a child in active addiction to heroin, prescription drugs, or opioids, that struggle is caused by ambiguous grief, not some weakness in the parent.
So how do we cope with the grief of a child’s addiction now that our grieving has a name?
The really cool chicks, Eleanor and Litsa, at “What’s Your Grief” suggest “it is important that you give yourself permission to grieve this loss. Acknowledge and express the pain of the loss, rather than trying to ignore or avoid the pain.” The experts at the Wendt Center agree, suggesting that we allow ourselves to take time to feel and express whatever emotions come up for us.
Knit together, this advice totals four separate suggestions, and I don’t like any of them. First, eating chocolate is the only permission I know how to give myself, but I think the kind of permission they’re talking about here is more like the “eat broccoli” type of permission. Second, feeling painful emotions sucks, so I don’t want to do it. Third, because feeling painful emotions sucks, actually setting aside and taking the time to deliberately feel pain will end up at the bottom of my to-do list. I’d rather eat chocolate. Fourth, expressing emotion is also problematic because, frankly, I exhaust family and friends when I express emotions.
Thankfully, both the Wendt Center and the WYG cool chicks emphasize the need to seek out support from other people who can relate.
Pass the tissues
For me, support groups are a gold mine of one stop shopping: first, I have to take and set aside time to go to a support group, which I think means I’ve given myself permission to go to a support group, so that checks off two of the four suggestions. Third, at support groups other people do the hard work of putting their feelings into words, and I can borrow from them to identify my own feelings. Fourth, most support groups give lots of leeway in the “expression” of feelings; they pass the tissues like civilians pass the salt. And, bonus!, they often have chocolate or are happy when I bring chocolate to share.
As parents, as we face the absence of the child we once knew, the theory of ambiguous loss gives us some explanation for what we are experiencing, and it’s an explanation that doesn’t BLAME the parents, which I personally appreciate. Ambiguous loss also emphasizes that we’re not alone, that there are proven approaches to managing our kind of grief. It gives us something TO DO: find support from others who understand, who walk our walk and cry our tears and ache in their hearts as we ache in ours.
PARENTS OF ADDICTS: WHAT'S WRONG WITH US
A mother is only as happy as her saddest child -- Chinese Proverb
The brittle stress, the penetrating fatigue, the stunned loneliness and social isolation, and the impotency of our parental love has a name. Well before the opioid epidemic scorched New Hampshire and Maine and Massachusetts and the states beyond, Dr. Pauline Boss at Harvard identified and defined the theory of ambiguous loss to explain the confused and often invisible pain of loving a person who is physically alive but psychologically or spiritually lost to us, or of loving a person who is physically lost or missing but not officially dead. She explains that ambiguous loss is an unclear loss that defies closure. Originally, Dr. Boss’ work applied to immigrants separated from family abroad, and then to the caregivers of parents sliding into dementia, but her theory is a perfect-fit explanation for the parental experience of loving an addict.
Dr. Boss is very clear that “ambiguous loss is a relational disorder and not an individual pathology. With ambiguous loss, the problem comes from the outside context and not from your psyche.” Which means that our parental pain comes from circumstances, not from self. There might have been plenty wrong with us personally before a chronic disease consumed our child, but what was wrong with us did not cause our pain. We do not suffer because we are weak; we suffer because our child is ill.
HOW DOES AMBIGUOUS LOSS AFFECT US?
Dr. Boss goes on to explain that:
“ambiguous loss is the most stressful kind of loss. It defies resolution and creates long-term confusion about who is in or out of a …. family. With death, there is official certification of loss, and mourning rituals allow one to say goodbye. With ambiguous loss, none of these markers exist. The persisting ambiguity blocks cognition, coping, meaning-making and freezes the grief process.”
The aching sadness we feel in the absence of the child we once knew is very, very real, but can, at times, feel like a shrieking self-centeredness and self-absorption. Giving the experience a name and classifying it as a theory studied at Harvard provides me with enough comfort and distance and language to better tell the truth: I experience ambiguous loss as all of the responsibility but none of the reward or privilege of parenting.
Ambiguous loss explains the cycle of desperate activity and advocacy -- the full force of my mother-love -- barreling down on a disease that threatens the very life and soul of my child, to utterly no consequence except the critical commentary of others and the toll of stress on my body, relationships, and ambitions.
The theory of ambiguous loss explains the soft melody of grief that now scores my life. My heart aches for something TO DO that will make a difference, but my heart aches even more over the loss of mutual relationship, growing friendship, and tender affection that I once enjoyed with my adult child. Ambiguous loss explains why my stability and wellness and ability to let go, to move forward with my life are now measured by how well I can pretend that my heart isn’t broken.
What is happening to us has a name. The soft melody that is the soundtrack to our broken hearts has a name. We’re not crazy and we are not weak. We are face to face with ambiguous loss.
Reprinted with permission from www.whenweloveanaddict.com. Copyright 2015 Kay Ryan
The Massachusetts’ Department of Public Health just revised the official tally of drug overdose deaths from 2014 (it will likely be revised yet again) and the results reveal that four people a day are dying in the Commonwealth State. Vermont now investigates four drug-related fatalities a week.
Imagine the public response if ebola or tainted meat or rat poison were killing FOUR people a day in Massachusetts. Imagine the panic if a viral pandemic had taken the lives of nearly 2,500 throughout New England in a single year.
Massachusetts Governor Charlie Baker has made it his mission to address the opioid epidemic; but Governor Baker has also talked about “better analysis of where and why people succumb to the disease."
Why people succumb? Such a question is based on a flawed premise and we should all resist the urge to agree with and to legitimize that premise.
People do not become addicted to opioids. I want to repeat that statement: People do not become addicted to opioids.
Opioids addict people.
It’s not semantics or word games. If meat is tainted with salmonella, we don’t examine why people who ate the meat succumb to food poisoning. If people are exposed to and infected by ebola, we don’t set out to examine why they succumb to the process of infection.
Addiction and infection and poisoning share a primary component: they all require exposure to a poisoning agent. No exposure, no illness, no tragedy. Is there a moral component or personal choice involved in nonmedical opioid use? Perhaps there is, if that’s where it feels good to put your focus. But have the courage to follow that moral culpability backward up the chain, from the cold table in the medical examiner’s office, back up to the needle, back along to the dealer who made heroin available and cheap when the Oxycontin supply shriveled, further back along the chain to the people diverting Oxycontin to the illicit market for profit, all the way up to the coffers of Purdue Pharma, who in 1996 flooded the pharmaceutical market with Oxycontin while lying about its addictive risks. And then follow the chain right back to its inaugural link to the $14 BILLION fortune that just landed the Sackler family — owners of Purdue Pharma — on the Forbes 2015 Richest Families list.
If we’re going examine the where and why of the opiate apocalypse, the foundational premise of our questions should be sound. And if we resist active community response to the drug addiction epidemic based on claims of morality, we should face those claims head on and responsibly by examining the entire chain of culpability.
Meanwhile, it’s likely that Massachusetts will soon announce that 206 additional fatalities have been added to the 2014 tally of drug users who died before they had a shot at drug rehab and addiction treatment.
<a href="http://www.health.ri .gov/data/drugoverdoses/” onclick=”__gaTracker(‘send’, ‘event’, ‘outbound-article’, ‘http://www.health.ri.gov/data/drugoverdoses/’, ‘Rhode Island data’);”>Rhode Island data
There’s a new game that people play with television commercials: mute a pharmaceutical ad and guess what the drug treats. Erectile dysfunction (middle aged couple, arms around each other, walking the beach, sunset)? Depression (single middle aged woman, wrapped in an oversized sweater, walking the beach, cloudy day)? Fibromyalgia (more than middle aged woman, white, potting plants, grimace turns into smile)? Incontinence (more than middle aged woman, walking beach with male partner, picking up stray volleyball and throwing it back to kids, big smile)? In the heavily massmarketed world of prescription medications and people walking on the beach, I can’t tell you what an OxyContin user looks like. So how did OxyContin become so popular?
The answer is innovative, aggressive, very costly, criminally deceitful marketing.
In the brilliant article, “Poison Pill: How the American Opiate Epidemic Was Started By One Pharmaceutical Company,” Pacific Standard, February 23, 2015, (http://www.psmag.com/healthandbehavior/howtheamericanopiateepidemicwasstartedbyonepharmaceuticalcompany) Mike Mariani reports that Purdue Pharma, spent $200 million in 2001 alone to market OxyContin. The New York Times calls Purdue Pharma’s effort “the most aggressive marketing campaign ever undertaken by a pharmaceutical company for a narcotic painkiller.” ( http://www.nytimes.com/2007/05/10/business/11drugweb.html?_r=1&)
Mariani points out that “Purdue's multifaceted marketing campaign pushed OxyContin out of the niche offices of oncologists and pain specialists and into the primary care bazaar, where prescriptions for the drug could be handed out to millions upon millions of Americans.” The campaign to push OxyContin was indeed multifaceted. Here’s a brief sketch of the strategy:
1. Promote OxyContin for NonCancer Pain
Mariani reports that “beginning around 1980, one of the more significant trends in pain pharmacology was the increased use of opioids for chronic noncancer pain. Like other pharmaceutical companies, Purdue likely sought to capitalize on the abundant financial opportunities of this trend. The logic was simple: While the number of cancer patients was not likely to increase drastically from one year to the next, if a company could expand the indications for use of a particular drug, then it could boost sales exponentially without any real change in the country's health demography. This was indeed one of OxyContin’s greatest tactical successes.”
Art Van Zee, MD, in his comprehensive 2009 article “The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy,” published in American Journal of Public Health , reports that “Purdue “aggressively” promoted the use of opioids for use in the “nonmalignant pain market. A much larger market than that for cancerrelated pain, the non–cancerrelated pain market constituted 86% of the total opioid market in 1999. Purdue's promotion of OxyContin for the treatment of non–cancerrelated pain contributed to a nearly tenfold increase in OxyContin prescriptions for this type of pain, from about 670,000 in 1997 to about 6.2 million in 2002, whereas prescriptions for cancerrelated pain increased about fourfold during that same period.”
2. Market to Physicians and Call It Education
Van Zee’s research found that “from 1996 to 2001, Purdue conducted more than 40 national painmanagement and speakertraining conferences at resorts in Florida, Arizona, and California. More than 5000 physicians, pharmacists, and nurses attended these allexpensespaid symposia, where they were recruited and trained for Purdue's national speaker bureau. It is well documented that this type of pharmaceutical company symposium influences physicians’ prescribing, even though the physicians who attend such symposia believe that such enticements do not alter their prescribing patterns.” Purdue threw in lots of logo’ed coffee mugs, pens, and ball caps as well.
3. Keep A Database
According to Van Zee, “one of the cornerstones of Purdue's marketing plan was the use of sophisticated marketing data to influence physicians’ prescribing. Drug companies compile prescriber profiles on individual physicians—detailing the prescribing patterns of physicians nationwide—in an effort to influence doctors’ prescribing habits. Through these profiles, a drug company can identify the highest and lowest prescribers of particular drugs in a single zip code, county, state, or the entire country. One of the critical foundations of Purdue's marketing plan for OxyContin was to target the physicians who were the highest prescribers for opioids across the country. The resulting database would help identify physicians with large numbers of chronicpain patients.” Van Zee also reports that, “Unfortunately, this same database would also identify which physicians were simply the most frequent prescribers of opioids and, in some cases, the least discriminate prescribers.”
4. Sales Rep Bonuses
Van Zee’s research also found that “a lucrative bonus system encouraged sales representatives to increase sales of OxyContin in their territories, resulting in a large number of visits to physicians with high rates of opioid prescriptions, as well as a multifaceted information campaign aimed at them. In 2001, in addition to the average sales representative's annual salary of $55 000...Purdue paid $40 million in sales incentive bonuses to its sales representatives that year.”
5. Target Primary Care Practitioners
The New York Times reports that “Purdue Pharma heavily promoted OxyContin to doctors like general practitioners, who had often had little training in the treatment of serious pain or in recognizing signs of drug abuse in patients.” (I added the bold in this section.) Van Zee reports that “Purdue promoted among primary care physicians a more liberal use of opioids...by 2003, nearly half of all physicians prescribing OxyContin were primary care physicians. Some experts were concerned that primary care physicians were not sufficiently trained in pain management or addiction issues. Primary care physicians, particularly in a managed care environment of time constraints, also had the least amount of time for evaluation and followup of patients with complicated chronic pain.“ Mariani makes the claim that by “Combining the physician database with its expanded marketing, it would become one of Purdue's preeminent missions to make primary care doctors less judiciouswhen it came to handing out OxyContin prescriptions.”
6. Offer “Starter” Coupons
While it’s not uncommon for pharmaceutical sales reps to provide physicians with an abundance of “sample” drugs, Purdue took the sample strategy even further, providing consumers, through physicians, with starter coupons good for anywhere from a seven to 30 day supply of free OxyContin. While a 30 day supply of any narcotic might raise concerns about developing drug dependence, OxyContin was promoted to doctors, and by extension patients, as a “safe” opioid.
7. Minimize Risk of Addiction
Mariani writes that right from its launch, Purdue set out to distinguish OxyContin from its competition. “The cornerstone of its marketing campaign was the drug's incredibly low risk of addiction, an enviable characteristic made possible by its patented timerelease formula. Through an array of promotional materials, including literature, brochures, videotapes, and Web content, Purdue proudly asserted that the potential for addiction was very small, at one point stating it to be "less than 1%.”” Sales representatives told some doctors that the drug didn't even produce a buzz, according to USA Today.
The New York TImes reports that “Among other things, company sales officials were allowed to draw their own fake scientific charts, which they then distributed to doctors, to support that misleading abuserelated claim.” Van Zee reports that Purdue “trained its sales representatives to carry the message that the risk of addiction was “less than one percent.” and that “a consistent feature in the promotion and marketing of OxyContin was a systematic effort to minimize the risk of addiction in the use of opioids for the treatment of chronic non–cancerrelated pain.” He goes on to explain that while research has established that 3% to 16% of the general population will experience some form of addiction within their lifetime, no credible study had determined the rate of “iatrogenic” addiction occurring during longterm opioid use for noncancer pain. “Iatrogenic” means “caused by medical treatment,” in this context, presumably as opposed to “caused by recreational use of illegal drugs.”
8. Hope the FDA Is Both Gullible and Cooperative
Mariani writes that “The timerelease conceit even worked on the FDA, which stated that "Delayed absorption, as provided by OxyContin tablets is believed to reduce the abuse liability of a drug." Armed with the timerelease formula and misleading statistics about the risk of addiction, Purdue positioned the drug as a relatively safe choice.”
The New York Times reports that “when the painkiller was first approved, F.D.A. officials allowed Purdue Pharma to state that the timerelease of a narcotic like OxyContin “is believed to reduce” its potential to be abused.”
Van Zee reports that “When OxyContin entered the market in 1996, the FDA approved its original label, which stated that iatrogenic addiction was “very rare” if opioids were legitimately used in the management of pain.” But then, in July 2001, “to reflect the available scientific evidence, the label was modified to state that data were not available for establishing the true incidence of addiction in chronicpain patients.” Iatrogenic means “caused by medical treatment.” Presumably, in this context, iatrogenic addiction differs from “caused by recreational or illegal use” addiction.
In 2007, in one of the largest federal criminal and civil cases ever against a drug company, Purdue Frederick Company, the parent of Purdue Pharma, pled guilty to and was fined $600 million for felony “misbranding” OxyContin. “Misbranding” is a broad statute that makes it a crime to mislabel a drug, fraudulently promote it or market it for an unapproved use. At the same time, three Purdue executives individually pled guilty to misbranding and were fined a total of $34.5 million. Announcing the federal verdict in 2007, The New York Times reported that “Purdue Pharma acknowledged in the court proceeding today that “with the intent to defraud or mislead,” it marketed and promoted OxyContin as a drug that was less addictive, less subject to abuse and less likely to cause other narcotic side effects than other pain medications.”
Similar cases against Purdue Pharma most notably in Kentucky are slowly winding their way through the court system.
The marketing strategy of Purdue Pharma relied heavily on systemic vulnerabilities. The FDA is understaffed and underfunded, and it cannot possibly keep up with its responsibility for the review and approval of pharmaceutical marketing materials. Many primary care physicians lack the specific training to monitor patients for addiction, and the managed care system squeezes the time and attention of even the most devoted healthcare providers. Sophisticated incentives and Big Brotherlike databases subliminally sway and influence prescribing habits, and criminally deceptive marketing materials promise physicians an opportunity to ease suffering a promise that preys on the very organic, benevolent motivations of healers.
OxyContin has made its way to the streets, and addiction has made its way into so many lives. Parents fight to accept powerlessness while at the same time fighting the cruel stigma attached to addiction. Stigma? Really? Where is the outrage? Where is the public awareness of and objection to evil, corporate, greed based manipulation of our entire healthcare system? Where is the compassion for prescribing physicians made complicit in an astonishing fraud that harmed rather than healed? We might all be more awake if we weren’t so massmarketed into a good night’s sleep, courtesy of Big Pharma.
Reprinted with permission from www.whenweloveanaddict.com. Copyright 2015 Kay Ryan
Drug Addiction Making BILLIONS for One Family
On July 1, Forbes Magazine’s announced its 2015 list of “Richest U.S. Families,” and a few hours later the New Hampshire Chief Medical Examiner announced its tally of 132 drug overdose death thus far in 2015.
There seems to be is a connection between the $14 billion fortune of one Connecticut family on the Forbes list and the funeral costs facing 132 families retrieving a loved one’s body in New Hampshire.
The Sackler family, dubbed “The OxyCotin Clan” by Forbes, owns 100% of Purdue Pharma, the tiny Connecticut company that developed, introduced, and then viciously marketed OxyContin. According the February 23, 2015 article “Poison Pill: How the American opiate epidemic was started by one pharmaceutical company,” after unprecedented, meteoric sales of just one drug, by 2010, “a single private, family-owned pharmaceutical company with non-descript headquarters in the Northeast controlled nearly a third of the entire United States market for pain pills.”
Does it then logically follow that the Sackler family initially controlled nearly one third of the OxyContin that found its way onto the street?
The History of OxyContin
Oxycodone a generic narcotic painkiller has been around since the 1910s, but in 1995, the Sacklers patented a special sustained release coating that would deliver the effects of oxycodone over 12 hours. They called it OxyContin.
The advantages of OxyContin over regular, generic oxycodone? Basically, every-four-hours dosing became every-12hours dosing. That’s it. Total practical benefit of the supposed miracle painkiller OxyContin.
Drug addiction, the Sackler way.
The early marketing of OxyContin as a drug offering little risk of addiction -- a claim driven by profits so large that it catapulted the Sacklers to their $14 billion fortune -- lulled physicians in small towns throughout America to distribute a supposedly benign tool to ease the suffering of factory workers with bad backs and roofers with bad shoulders and truck drivers with diabetes and little old ladies recovering from knee replacement. Because Sackler marketing encouraged a much broader application of its “safe” opioid product, to a market beyond cancer pain management, primary care doctors felt armed to address the chronic pain complaints of patients and quadrupled pain killer prescriptions of all types in the first decade of the 21st century.
The American Journal of Public Health reports that with the introduction of OxyContin, between 1997 and 2002, fentanyl prescriptions increased by 226%. Morphine prescriptions increased by 73%. And generic, every-four-hourdosing oxycodone prescriptions increased by 402%. Doctors, now able to ease immediate suffering, became desensitized to the implications of long-term prescription narcotic use. In one of healthcare’s greatest bait and switch schemes, OxyContin was marketed to alleviate temporary or chronic suffering for the individual, yet by deliberately minimizing the risks of addiction, OxyContin instigated long-term suffering for the tens of thousands eventually felled by a nationwide epidemic of addiction and death.
The Connection Between OxyContin and Heroin
The American Journal of Public Health explains that the jump from 316,000 OxyContin prescriptions written in 1996 to the 14 million prescriptions written between 2001 and 2002, “correlated with increased abuse, diversion, and addiction, and by 2004 OxyContin had become a leading drug of abuse in the United States.” OxyContin, simply because there was so much of it, “trickled down from pharmacies and hospitals and became a street drug,” explains "Poison Pill." This “trickle down” cascade is also known as “diversion,” meaning the drug finds a detour from the legal intention of a doctor’s prescription pad to the pocket of a street customer willing to face the risk of addiction in exchange for a Saturday night of euphoria.
The Oxy high carries a big bang. Four years after the FDA approved an 80mg version of the pill, it approved a 160mg tablet specifically for opioid tolerant patients. "Poison Pill" concludes that
These high milligram pills were probably one of biggest reasons that OxyContin became such a popular street drug. Recreational users and addicts could crush, sniff, and inject the pill for a powerful high that, as promised, lasted over eight hours. The euphoric effects and potential for abuse were comparable to heroin.
Abundant, accessible, and much less expensive than OxyContin, heroin use has merged with prescription drug abuse to create the exploding opioid epidemic of addiction, crime, incarceration, rehabs, homelessness, heartbroken parents, and premature death. "Poison Pill" calls this merging of prescription and street opioids an evolution, that, much like a virus, mutates and spreads to better invade its hosts or victims.
Call it a virus, a mutation, an epidemic, a public health crisis, a tragedy. The New Hampshire Medical Examiner calls it a tally. Forbes Magazine calls it a fortune.
Republished with permission from www.whenweloveanaddict.com.
Copyright 2015 Kay Ryan
People-First Language for Drug-First People
Are we part of the problem if we call our addicted child an addict or alcoholic? Because, they say, such labels perpetuate the moralistic stigma that cascades into less accessible drug addiction treatment, prison overcrowding fueled by the opioid epidemic, public resistance to needle exchange programs, and maybe even drought in California?
Sorry for the sarcasm, but I’m a little sick of hearing about all the ways I’m contributing to a problem I’d do just about anything to fix. But, like anyone who loves an addict (oops), I’m going to dig deep and yet again find maturity and open-mindedness and compassion enough to try to understand why the world might be a better place if I humble myself enough to consider a new language. Here goes.
According to the federal Substance Abuse and Mental Health Services Administration, the labels "drug addict" and "alcoholic" are demeaning because they define a person by his/her illness:
"By making no distinction between the person and the disease, (the labels) deny the dignity and humanity of the individual. The labels imply a permanency to the condition, leaving no room for a change in status."
I could make a pretty good argument that it’s the opiates that rob the individual of dignity and humanity, and that the use of the “addict” label confronts – rather than denies – the depersonalizing reality of addiction. I could make a pretty good argument that the condition of addiction IS permanent unless chronic drug use stops, and that I’d be foolish to think words or a change of words provide any defense against the crippling, soul-thieving power of heroin.
Really, I could make the argument. Or I could sit back and let heroin make it for me.
What Is “People-First” Language?
The Americans With Disabilities Act (ADA) of 1990 launched an era of awareness, advocacy, and accessibility that led to the concept and practice of people-first language – language that highlights and respects the worth and dignity of all persons, rather than prioritizing our focus on a disability at the expense of our awareness of the person.
In the context of addiction as disease, according to the professional journal Substance Abuse:
People-first language literally puts the words referring to the individual before words describing his/her behaviors or conditions. This practice helps highlight the fact that an individual’s condition, illness, or behavior is 'only one aspect of who the person is, not the defining characteristic.'
But, for me, if I’m living in reality, I have to see that addicts literally put drugs before people, and that the practice of putting drugs before people highlights the fact that addiction IS the defining characteristic of the active addict.
The Substance Abuse editorial goes on to explain that:
In the realm of addiction, terms such as “alcoholics,” “addicts,” "users".... linguistically erase individual differences in experience.
Here’s where I struggle: is it even possible to linguistically erase individual differences in experience when heroin has already robbed addicts of all individuality? Opioids send the addict into a la-la land of generic oblivion and then into a generic cycle of withdrawal and drug seeking where drugs are first and the people who love addicts don’t even make the cut. Isn’t active addiction pretty much characterized by a complete lack of any unique or individual experience, goal, talent, or relationship?
To be fair, the Substance Abuse editorial, titled “Confronting Inadvertent Stigma and Pejorative Language in Addiction Scholarship: A Recognition and Response,” is directed at researchers, health care professionals, and scientists in the field of addiction medicine rather than at the families and individuals who struggle every day to love an addict, to get a good night’s sleep, to breathe, and to hold onto hope while simultaneously holding on to wallets.
And the journal isn’t alone in calling for people first language. From a wide variety of agencies and experts, a sampling of the “preferred” terminology:
Person in active addiction
Person with a substance misuse disorder
Person experiencing an alcohol/drug problem
Individual with addictive disorder
Person with AOD (alcohol and other drug) problems
Person who uses drugs (PWUD)
Person with alcohol dependence syndrome
Person with substance induced disorder
What Are Compassion-first Eyes?
I’m sure the encouraged shift in language is intended to sway professional and public opinion away from language that reinforces moralistic judgment rooted in ignorance and prejudice and move it toward avenues of discussion and advocacy, all for the benefit of recovery from addiction and alcoholism. I’m sure the mindfulness toward language isn’t meant to level another hammer of criticism or fault toward families already suffering the heartache of addiction. But, really, sensitivity and empathy and compassion don’t originate along the linguistic pathway from head to tongue; authentic recognition of humanity is born in the heart and revealed in the eyes.
The readership of professional journals such as Substance Abuse are likely concerned with the primary costs and policies associated with the huge public health crisis brought on by inappropriate opioid use. But secondary consequences manifested in the families of persons with substance induced disorders – the financial strain, the insomnia, the stress, the lost wages and employee absenteeism, the hypertension, the depression, the anxiety, the fatigue – create an exponentially greater public health crisis concern.
When the mother of an addict reaches out to any social or healthcare professional – when she lets her shoulders droop, lets the tears well, confesses to the chronic headaches and inflamed joints and terrifying impotence of her love – she doesn’t need people-first language. She needs you not to look away.
Get it right in the eyes and it won’t matter so much what words follow.
I can Google the April 2015 slaughter of young people, the latest victims in an epidemic that costs us all, and I will come up with the horrific and heartbreaking news stories, the boldly brave statements of grieving parents, the groundbreaking obituaries. Jessica McCassie in New Hampshire, Molly Parks in Maine, Cathleen Melanson Wyman in Massachusetts, and almost surreally and
inevitably, Daniel Francis Montalbano in Florida.mountainsphoto
“Victim” of opioid addiction is sort of a misplaced term, since the pain has stopped for the kids who are dead. Real victims of the opioid or prescription painkiller or heroin epidemic are the mothers, fathers, children, friends, and partners who have been exhausted in their ongoing fight against denial, disintegrating hope, stigma, stress, impending doom, insufficient drug detox
services, unpredictable drug treatment outcomes, and now final grief.
Parents, the mothers in particular, find ourselves caught in a constant state of dual powerlessness: we are powerless over the path of a chronic disease and we are powerless over the evolutionary programming of our very DNA.
Parents do not think before snatching a child from the path of an oncoming vehicle; it’s an involuntary, full body, selfdisregarding response to threat. But even when a child is on the brink
a three year old hanging his toes over the curb alongside speeding traffic parents experience that same involuntary, full body, selfdisregarding response to impending threat and they grab the child, pulling her back to safety.
In danger or on the brink of danger it’s all the same to parents.
Those Awkward Contributions from People Who Don’t Get It
Someone just asked me, “Don’t you think most parents of drug addicts are really just trying to help themselves? Trying to get their kid into drug treatment just to alleviate guilt or so the parents can get a good night’s sleep?”
I’m a multitasker, so I have multiresponses to that question. Some I vocalize and some I keep to myself. They are:
Maybe. My kind, tempered, diplomatic response, one honed from (inconsistent) practice of meditation and green smoothies and support group attendance.
You’re an a-hole. My quickest response, honed from sleepless nights, deliberate documentation of my child’s tattoos and birthmarks, thighs now molded by late night ice cream and crinkled from
diminishing estrogen, a pockmarked bank account, the chalky taste of Maalox that constantly coats my mouth, and the certainty that you’d never ask that question of a parent who just saved a child from drowning or who just snatched a toddler away from the edge of the deep end.
That question makes me defensive, and I need to look at where or how it threatens my belief system. My selfsearching response, honed from 12step work, constant selfappraisal, learning the benefits of an open mind, and an increasing, although begrudging, awareness that I’ve become a little hostile, impatient with fools, and more than a little isolated in my newnormal whirlwind of constant urgency and adrenaline.
What difference does it make (and why can’t you find just a little compassion to counter the criticism)? My soulweary response, honed from an ongoing and terrifying fatigue that permeates every cell of my body and mind, a hypersensitivity and defensiveness that seem to have settled in my very marrow, an almost desperate craving for comfort and kindness and a quiet hug, and the now certain knowledge that if you don’t “get it” nothing I say can change that.
And finally, Your freedom to ask that question comes from a place of deep blessing that makes me feel joyful for you and yours. My most honest response, honed from the understanding that you don’t get it because you have been blessed with healthy children, that your cold questions or ignorant comments or arrogant lectures spring from an utter lack of experience with my particular brand of heartache, a heartache I would wish on no one. And so I feel joy for you and yours, for the blessing of your inexperience with chronic disease and with the parental agony brought on by a suffering child.
“I needed to connect with the primal emotion of a mother’s love and the desperation felt when that love is put under siege by the horror of a child’s addiction,” Barbara Theodosiou explains to John Lavitt of thefix.com www.thefix.com , a recoverybased website that’s a great source for discussion, education, and recovery topics in the news. Barbara is the founder of “The Addict’s Mom” www.theaddictsmom.com the groundbreaking support resource TAM for short that offers a safe haven for mothers faced with the nightmare of experience. TAM also offers a little vacation from those “blessed” people, the ones who don’t get it. Its online support groups there’s one in every state allow mothers to “share without shame.” For a group in your state go to www.facebook.com/groups/TAM and then add your state to the address (for example, www.facebook.com/groups/TAMNewHampshire).
On The Addict’s Mom website www.theaddictsmom.com , Barbara Theodosiou explains the motivation that led her to create TAM seven years ago. “Deep inside I knew I was not the only mom suffering. I knew there had to be other mothers who were going through the same emotional pain that I was. I wanted to create a place for mothers of addicts to have the freedom to share our pain without feeling the shame that often comes with having a child who is an addict. As the mother of two addicts, it took me four years to realize that I matter, that my life has purpose. I didn’t have to die inside because my sons were addicts. I am learning that I am important to myself and other people in my life, including my husband and other children.”
Moms go to TAM to find help, and that help morphs into friends which morph into sisters. No lectures or “you shoulds” or “why don’t you justs.” No shame, no blame, no criticism. Just a forum for women learning how to live and cope with the reality that a mother’s heart will be shattered with that one dreaded phone call. Molly Parks’ mom received it. Cathleen Wyman’s and Jessica McCassie’s moms received it. And sadly, this April, the call came for Barbara Theodosiou: Daniel Montalbano was her beloved son.
Reprinted with permission from “Whenweloveanaddict.com”. Copyright 2015. Kay Ryan