Editor’s Note: When I first began writing about the opioid crisis, the end seemed simple, though not easy. Rehab was obviously the route to go for overcoming addiction, and though I realized money could be a substantial barrier, I didn’t know how complicated the issues of addiction, drug use and the opioid epidemic really are, how deeply they seep into the lives and communities upon which they feed. Essentially, I didn’t know what I didn’t know.
Many months later, after interviews with people who use or have used drugs, parents, social workers, community health experts, doctors, lawyers, and everyone in between, my perspective has changed. The answers are no longer pat, no longer simple and clear. But they do exist, the answers, and there is hope, and healing.
Many of the people I’ve spoken with have asked me not to name them, in large part because their stories are not only their own. They are stories of their children’s addiction, of their spouse’s addiction, of a close friend or lover’s struggle with drug use and dependency. I have heard time and again, “Please don’t print my name. I don’t care if people know my story, but my daughter’s story isn’t mine to tell.”
I’ve interviewed several people who, days before an article was set to go to print, retracted the entire interview and asked me to tell nothing, not even under assumed names, not even with changes that might obscure identity.
I have obliged. Such is the nature of this subject.
There is a fine line between storytelling, reporting, and exploitation, and I would rather sit frustrated in my office, a blank screen in front of me where a story once lived, than know that I somehow contributed to making someone’s story worse, someone’s pain tighter, even if I could find a technicality to excuse that retelling.
But as I ponder how to write this final piece, exploring where to go from here and how we might all help each other address opioid use disorder, all of those stories, interviews, suggestions, and statements speak to me, as if they’re voices independent of the person who first spoke them, each one sitting in a chair in my office, hand raised, waiting to be heard. So, without names or dates or identifying markers, here is what I have learned about what we can do, where we can go, and how we can help individuals, families, and communities recover from an epidemic of opioid addiction.
Individuals: From interviews with persons in active recovery to persons currently using drugs to family members who have both seen their children recover and visited their graves after their death from overdose, here is the advice for the individual struggling with opioid (or any drug/alcohol) dependency or addiction who wants help:
Reach Out – Ask for help from people who can support your recovery rather than from friends who are currently using drugs. Reach out to parents, friends, community health workers, and clergy. As one parent says, “Be open and honest. I think that’s one of the things that my daughter was not because she feared. There is so much fear of the punishment that might come along that they don’t open up to the parents who can help them and who love them. Their parents love them, and of all the people in the world, the parents are the people who will be there to help them.”
Find Help – Navigating the process of recovery is neither simple nor easy. Support is necessary for ongoing recovery, so finding someone who can help you begin the process of recovery and finding help navigating the ongoing process is important. This might be in the form of a mentor, a sponsor, a community health worker, or a peer support specialist. Peer support specialists are people who have lived with addiction themselves and who understand the experience of drug use and recovery, people who have lived experience, who can relate, respond and understand where you are and help you navigate through the necessary steps of treatment, whichever form that takes. Roxanne Elliott, Policy Director of Community Health Services for FirstHealth of the Carolinas, says, “Peer support specialists can help you navigate the process and help you determine the best path to recovery.”
Be Open – There is no one path to recovery. There is no magic pill, no one program, no fail-safe solution that will work for each person, as each person is unique. Each circumstance is different. Some paths to recovery involve Medication-Assisted Treatment (MAT) and counseling. Some paths include formal rehabilitation at residential treatment centers. Some paths include Alcoholics Anonymous or Narcotics Anonymous, which are both 12-step programs based on the abstinence model of recovery. There is no one-size-fits-all recovery program or path, so be open to options and find the best fit for your own circumstances, personality, and future. Britteny, who is inactive recovery, doesn’t use AA, for example. She says, “That just really triggers me. I don’t want to sit and talk about the times I got high. A lot of times, that’s what they do, and that triggers me to want to get high. I like reading the book, the NA book, and I relate a lot to the book, but as far as meetings, I don’t do it.” Another woman, Nancy, has maintained her sobriety for 20+ years through the use of AA. She says, “Just try it, AA. If you don’t like it, you can walk out. If you don’t like what you see or hear, you can leave. But those who stay, stay sober.” Clint relies on his newly-found faith (and support through a men’s program of faith, fellowship, and fitness called F3). Just before entering rehab, Clint says, “For me, I became really desperate to get help. I was an atheist, but I became desperate enough to pray. I was desperate enough to try. And when I did, this huge catalyst of events [began] that ended up saving me.”
Families and Loved Ones: Parents, siblings, loved ones, and caregivers all find themselves asking: what can I do? What should I do? What must I do to help my child, brother, sister, spouse, or friend overcome opioid use and addiction before it’s too late? I’ve asked people in active recovery what their parents or spouses could have done to help them. I’ve asked community health workers what family members should do. I’ve spoken with police officers and peer support specialists about this very topic, and here are the suggestions, based on lived experience, for family members and loved ones of persons living with addiction:
Set Boundaries – Time and again, from people using drugs to parents who lost children to overdose, I heard the same refrain: do not enable persons using drugs. Finding the line between loving a child or a loved one and enabling him or her is difficult and, no doubt, an individual, unique decision, but focusing on creating strong boundaries is key in helping people who struggle with addiction. Karen Wicker of Drug-Free Moore County is quick to point out that love is a key component of recovery. She says, “Parents don’t have to like the addiction, but they have to love their child. The message of cutting the user off is an old message.” Boundaries, however, are important. Clint, who is now inactive recovery, answered the question of what someone could have done to help him during his addiction in saying, “Let me suffer the consequences of my poor decisions.” Brittney says when asked what she would say to a parent of a child using drugs, “Don’t enable them. It’s hard for parents. It’s hard to tell them no. But don’t let them come home. As hard as it is, you have to tell them no. You have to show them, the kids, let the drug addict hit rock bottom. Let them have nowhere to go, no food to eat, as ugly as it sounds, that’s what it’s going to take. As long as your enabling them, they have a roof over their head, they’re gonna keep using. They’re comfortable as a drug addict. They’re not having hard times.” A father whose daughter uses drugs and who works in recovery ministry, who asked to remain anonymous, says, “Don’t give them money. We associate love with giving money to fix their problems, but that does more harm than good. I think in Western culture, we think money is the solution. It’s not. That’s the easy thing, to write a check. That does more harm than good. We can help by giving them our time.”
Support Yourself – It’s important for caregivers and loved ones to find and engage in support for themselves. Supporting people who are inactive addiction and struggling with drug use is emotional and often overwhelming. Loved ones are often over-extended in many areas including having depleted emotional, financial, and physical resources. Having spent time with grandparents who are raising grandchildren as a result of the opioid epidemic, many of these caregivers described the heavy toll of caregiving in all of these areas. Self-care, community, and connection are as important and helpful for caregivers and loved ones as they are for persons in recovery. As Elliott says, “Caregivers are going through their own series of emotions. PAL groups [Parents of Addicted Loved Ones] can be helpful, and parents can help facilitate these support groups.”
Know Your Role – Caregivers, loved ones, parents, siblings, and friends all want desperately to help. We want to place phone calls, book beds in rehab facilities, stage interventions and collect information, but knowing when to engage and when to let go are perhaps the most important lessons for loved ones to learn on the path to recovery. One father, when asked what he might say to another parent with a child struggling with addiction, says, “I encourage them there’s hope, but you have to learn to let go, let go of trying to fix them and to control it.” One peer support specialist and mother of a son who died from an overdose, Stephanie, says, “When you say you’ll take them to rehab and they keep pushing it off, that person is telling you: I’m not ready. If it’s your decision, there’s a chance it won’t work. If it’s their decision, it might work. You’re putting so much of your heart, mind, and soul, hoping, wishing, and wanting something that person isn’t willing to do. Your want can’t be more than they want. It has to be their decision.”
It’s an easy suggestion to make, the idea that we step back from the ones we love and embrace our role as supporters rather than decision-makers. It can often feel like giving up rather than doing what we most want to do, what we badly ache to do, which is to take action. But, when asked what advice she would give a spouse living with a partner struggling with addiction, mother and widow Amy say, “Support them from a distance. That’s the healthiest way to do it. You can still have contact, but let them figure out what they want to do on their own. You can’t choose that for them. They have to do that on their own.”
Communities: The opioid crisis affects not only persons who use drugs and the people closest to them but society as a whole, at both the local level at a much broader, national level. From the neighborhoods we live in, to the classrooms in which our children attend school to the congregations among whom we worship, we are all impacted by the epidemic of addiction plaguing our communities. The question becomes: what can we do to provide support to promote hope and healing throughout our communities?
Reduce Stigma – stigma is often identified as one of the primary barriers to treatment and recovery faced by many persons using and/or addicted to opioids. Part of reducing stigma is using respectful language, free from judgment. For example, rather than using the word ‘addict,’ we can simply say ‘person who uses drugs’ or ‘person with substance use disorder.’ The words we use matter in helping reduce the stigma and shame surrounding this disease. Bruce, whose ex-partner suffers from substance abuse disorder, says, “Shame is such a volatile part of that recipe of addiction, getting sucked into that. I imagine if you can slay the dragon of shame, you can repair the rest of the person, but getting past the shame is the hardest part.” As Stephanie, whose son died from an overdose, says, “When you take the word addict or junkie out of it, you’re a user. Now I see you as a human bring. When people said Alex was an addict, they didn’t see him as a human being. When you say: Alex uses drugs, then you have a question behind it. Why? Why is he doing that?” Programs like that currently ongoing with FirstHealth of the Carolinas provide stigma training for law enforcement and first responders so they might better understand the epidemic from multiple perspectives including those of drug users and caregivers. One father says, “I think, worldwide, the stigma needs to be removed. We all have bad habits – shopping, pride, junk food, whatever it is. I think just embracing it is key. Most communities want to ignore the problem, get rid of drug users, throw them in jail. Maybe the main thing is that the community needs to educate itself about addiction so that we can be more loving to the people struggling with addiction.”
Support Pathways for Treatment – Whether it’s through financial means or by donating time and expertise, the pathways to treatment and recovery are varied. Karen Wicker says, “Not one treatment will work for each person. Some people go through several treatments.” Included in recovery is aftercare, which many experts agree is equally (if not more) important than rehab and detox. One parent agrees, “It’s not rehab programs that define success; it’s the aftercare. The aftercare is what is important, and there was none for us.” Aftercare includes out-patient programs, life-skills development programs, counseling, support groups, parenting classes, and more. Community support and involvement in providing these services are crucial for the ongoing and long-term recovery of substance abuse disorder, from the physical recovery of the person to the mental, emotional, and spiritual recovery as well. Programs like F3, Alcoholics Anonymous/Narcotics Anonymous, and local programs such as Moore Family Connections all provide on-going support for recovery and help build coping skills and life skills necessary to live in active recovery. Supporting these programs and helping create other opportunities for support is an important aspect of community involvement. As Wicker notes, “When you’re in active addiction, you do lose your job, your kids, and your house. You have to build these skills to go back to a well-functioning life.”As one parent reminds us, “You need a whole team of people if you’re going to climb Mt. Everest. You need Sherpas. You need people who’ve done it before. You need trainers.” Elliott reminds us, “Recovery and treatment are much more complicated than rehab. There is food security, housing, transportation, mental health support, etc. It’s a complicated web of need and support.”
See the Hope – With awareness, education, and conversations, we learn, as a community, not only the details and statistics of opioid abuse disorder but also the hope for healing and recovery. Wicker says, “Prevention comes with awareness. We’ve got to support the fact that recovery is possible.” Sharing stories of recovery, healing and hope is key in educating the community about the possibility of active recovery and the steps necessary not only to engage in such recovery but to overcome the fear of admitting the need and reaching out for help. Hearing from people who have lived in active recovery and sharing their stories encourages hope within the community. Clint, who lives in active recovery says, “During my addiction, I couldn’t imagine I would be going to college or thinking about planning my life about trying to be an advocate for recovery and for helping people. I didn’t see that I could give back to the world instead of taking from it.” Britteny, now married and able to fully support and care for her two children, says, “Now I’m free. I’m happy. I love life. My eyes are clear. My mind’s clear. I never thought I’d be where I am now.” In sharing their stories, in educating our communities about how we can help and engage, and in exploring ways to promote and encourage hope, we heal from an epidemic that affects us all.
The opioid crisis is a multi-faceted crisis deserving a multi-pronged response. As one law enforcement officer told FirstHealth’s Roxanne Elliott, “We’re not going to arrest our way out of this.” We must, as individuals, families, and communities, reach out to each other, connect with each other and provide resources, support and hope so that we all heal from the effects of this epidemic and realize our potential removed from addiction and dependency, our potential as human beings rather than statistics.
Resources
FirstHealth of the Carolinas
With recent grant funding, FirstHealth of the Carolinas is partnering with organizations within the Sandhills region to bring awareness, hope, freedom, and recovery to those struggling with opioid addiction and dependence. The Sandhills Opioid Response Consortium serves all individuals impacted by opioid addiction through collaborating with partners to create access to treatment and recovery resources and programs.
Please visit www.firsthealth.org/recoveryresources for information related to:
Awareness/prevention
Treatment/recovery centers
Medication Assisted Treatment (MAT)
Peer support services
Resources
Harm Reduction
Stigma Education
Caregiver Resources
The Consortium’s work includes increasing awareness and stigma education, building peer support programs, providing resources in faith communities and schools, increasing access to and streamlined flow toward treatment and recovery, implementing screening protocols, implementing the use of rapid response teams, and decreasing the number of ED visits.
For more information, please contact Roxanne Elliott by emailing rmelliott@firsthealth.org or call 910-715-3487.
Drug-Free Moore County
Visit Drug-Free Moore County’s website for resources (including phone numbers, addresses, websites, and more) related to recovery, intervention, treatment, support, and aftercare for substance abuse and dependency.
www.drugfreemc.com
Alcoholics Anonymous
www.aa.org
(visit the website to find a local
meeting/location)
Narcotics Anonymous
888-835-8801/www.ncregion-na.org
F3
F3 is a national network of free, peer-led workouts for men. The organization’s mission is to “plant, grow and serve small workout groups for men for the invigoration of male community leadership.” The website also has links for women’s programs.
www.f3nation.com
County health departments are also excellent resources for information related to substance abuse, treatment, and recovery.
Reading Resources
Drug-Free Moore County’s Executive Director, Karen Wicker, recommends:
The Language of Letting Go: Daily Meditations on CodependencyMelanie Beattie
Why Don’t They Just Quit:
Hope For Families Struggling
with Addiction
Joe Herzanek with Judy Herzanek
Recovery 2.0: Move
Beyond Addiction and
Upgrade Your Life
Tommy Rosen
Understanding Addiction
and Recovery Through a
Child’s Eyes: Hope, Help
and Healing for Families
Jerry Moe, MA
Editor-in-Chief Amy Phariss recommends:
Dopesick: Dealers, Doctors, and the Drug Company that Addicted America Beth Macy
In the Realm of Hungry
Ghosts: Close Encounters
with Addiction Gabor Maté, MD and
Peter A. Levine, Ph.D.
The Body Keeps the Score: Brain, Mind, and Body in the Healing of TraumaBessel van der Kolk, MD