Parent Partners: Making an Impact

Addiction Treatment in America - A System Of Care That Doesn't - Part II

A couple of months ago my wife woke me in the middle of the night complaining of chest pains and difficulty breathing.  After several calls to her sister, an ER nurse for many years, I dialed 911 and an ambulance arrived within minutes to whisk us off to the hospital.  As the EMT's wheeled her gurney into the emergency room I noticed a young adult male lying in a fetal position and alone two rooms down from where we ended up.  Over the next three hours my wife went through a battery of procedures and tests ordered by the attending physician which in the end determined that her condition was not life threatening.  She was given a couple of prescriptions, a referral to schedule an appointment with a specialist and discharged into my care. 

As we left the ER at 4:00 AM to head back to the comfort of our home armed now with the tools we needed to hopefully address my wife's medical condition, I noticed the young man I had seen earlier in the evening was still in the same room; still huddled up in the same fetal position and still alone.  I asked one of the nurses what his story was...and with a tired look in her eyes she said...

"Just a drunk that we're letting sleep it off....that's all we can do." 

Election Day 2008

The incredible excitement and the inescapable historic nature of this past election night reminded me that it was not long ago that I hated election day.  It never had anything to do with the politics, the candidates, issues of the day or the long lines at the polling stations.  My distaste for the first Tuesdays in May and November was simply rooted in the fact that in the State of Indiana the sale of alcohol is prohibited on those days until 6:00 PM.  A relic from the Prohibition era when saloons sometimes served as polling stations,  Indiana is only one of four States that still clings tenaciously to it's temperance traditions.  

 

As a closet alcoholic for more than two decades, Election Day was such an incredible inconvience to me, one for which I was perennially unprepared and resented each year.  But today with the help of my higher power and 12 Step programs I can look forward to exercising my patriotic right and celebrate the democratic process without being restless, irritable and discontent. 

 

Today I look forward to election day and that is just another gift of recovery.

Addiction Treatment in America - A System Of Care That Doesn't

Carlie walked into my office with a perplexed look on her face.  She has worked with me for sometime now and knows from past experience that not all my calls are work related....work that I get paid a salary for that is.   She handed me a piece of paper and said "I just took this message off my voice mail from a treatment center who referred this woman to you...it sounds like she needs help."  I was confused by the message since I am more often the one doing the referring of people to treatment centers.  But when I returned the call I quickly understood that this was the kind of contact my wife and I have received frequently since the death of our son David from the disease of addiction in 2001.

The call for help came from a family who had heard about our work since Dave's death, were now confronting their daughter's escalating addiction and a treatment system of care that seemed disjointed, confusing, extremely difficult to decode and to navigate.  They were a family like us, well educated and affluent, who never thought this would happen to them.  Like us they spent some time trying to deal with things themselves and then realized they needed "professional" help. Yet when they entered this new arena of substance abuse treatment they found they didn't understand the syntax, the answers they received or the questions they needed to ask. What they needed was a translator, a guide or perhaps a sponsor...someone to help demystify the process for them; that is how they ended up contacting us. 

For most health threatening issues the public health model, or system of care, works pretty well.  Individuals with health problems enter these systems via their primary care physician, a psychological specialist, an immediate care facility or in extreme cases through the emergency room of a hospital.  From there a well established system of medical specialists takes over to guide the patient through a prescribed regiment of treatment more often than not underwritten by insurance that covers some portion of the cost.

Unfortunately those who require treatment for a substance abuse disorder do not enjoy a similar cohesive and coherent system of care.  Many health care professional from doctors to emergency room personnel demonstrate an appalling lack of knowledge about the disease of addiction or the treatment it requires.   Most health insurance companies provide meager coverage at best and many private not-for-profit treatment facilities require up-front down payments ranging from $6,000 to $15,000.  To say that our system of care for the treatment of addiction is broken would seem to indicate that we had a system that worked at some point.  In my view we never had one that worked and the one we have right now still needs an incredible amount of work.

Which brings me back to the family who found their way to us.  Their call led to several more conversations, an invitation to meet with us at our home that was gratefully accepted where the translation and interpretation began.  Their daugther just completed two weeks of in-patient treatment and is now on to the next chapter of her recovery. 

We are still on-call for them and will be there for them for as long as they or anyone else needs us.

Adolescents Finding Recovery

I finally groped my way into recovery at the age of  51.  I started using when I was 15 which means I spent 36 years chasing what I thought were the feelings of peacefulness and serenity alcohol and drugs brought me.  36 years before I realized that it was all a lie, false promises from a false God I had worshiped for over three decades.  And while the program of Alcoholics Anonymous teaches us that if we work hard at recovery we will not regret the past...nor wish to shut the door on it, there are times that I wish that it has not taken me so long to get sick and tired of being sick and tired. 

If you have read any of my previous entries you will know that I am fond of speaking of the truths that I have learned along this circuitous rocky road of recovery.  Prominent among there are that while I shrank back at age 51 when I was told I could not drink the rest of my life I cannot begin to appreciate how difficult, scary and intimidating the concept of total abstinence from drugs and alcohol is for an adolescent or young adult.  The road to sustained recovery is an arduous one for everyone but for young people it is especially so.  They exist in a culture of excessive consumption in which they define themselves by their relationships with peers.  Acceptance by others and being comfortable in ones own skin are most often the cornerstones of identity and for many use and abuse of alcohol and drugs is the fast-track to "fitting in".

When our son David was first in treatment we learned that alcoholics and addicts are surrounded by a cluster of  family and friends who directly or indirectly enable that person's using behavior.  Adults who suffer from the disease of addiction usually have anywhere from 5-10 people who make up this cluster of "enabler's".  For adolescents and young adults there can be upwards of 25 to 35 people who enable them. So when a counselor or 12 Step sponsor tells a young person that one of the key components of  sustaining recovery is to change "people...places and things" it's no wonder that despair and fear can follow.  Alcoholics Anonymous' one size fits all philosophy designed by middle aged, white males has done little to help.  Perhaps  AA would do well to take a chapter from their Al-Anon brothers and sisters and consider a program similar to Al-Ateen to make 12 step recovery more accessible to young people.

Still the good news is that thousand of adolescents and young adults do find recovery everyday through treatment and 12 step recovery programs despite the appalling lack of treatment facilities throughout the United States and continuing discrimination by health insurance providers. I never cease to be filled with admiration for the young person who finds their way into recovery no matter what the path.  One of the common laments of men and women in the rooms of AA, NA, or CA is..."I wish I could have found recovery when I was younger."

So when I see a young person tentatively and reluctantly enter a treatment center or a 12 step meeting I feel hope and promise for their own recovery...hope and promise for the thousands who haven't made it yet...and hope and promise in the knowledge that if they do find recovery in their youth they will enjoy many more years of recovery than I will have the chance to experience in the time that I have left. 

Substance Abuse - Not A Personal Choice

The call came in at 1:35 AM.   

There was a time not so many years ago that a call at this hour would have brought a chill to my heart as I tentatively reached for the phone with both fear and desperation rising in my throat.  Emotions that any parent of a young person struggling with addiction knows all too well.  But since David's death from substance abuse some seven years ago I no longer fear these nocturnal disturbances to my slumber because they hold no power over me.  I have had the worst from life in losing a child and so I gladly let the call go to voicemail to be retrieved in the light and the hope of a new day.

The next morning, as I sat on the edge of the bed listening to the message from the night before, I knew from the first halting words that heartache and suffering were at the core of the call.  It was the voice of a close friend of Dave's calling to tell us that the 16 year old younger brother of a mutual friend had been killed in a car accident the day before.  And while the scope of this tragedy was considerable for Dave's friend it was really more the painful memories it conjured up within him, goodbyes left unsaid, self-recriminations over lost chances, unspoken words that haunted him still ...all these had prompted his call. 

Now after seven years they all came cascading out...dislodged by a new grief that caught him unawares and took him back to a time and a place that he had kept from everyone and especially from himself.  He reminded me of the day at Dave's "calling" when he kept getting in and out of the receiving line, afraid to face us because he would not know what to say.  He recalled that I had finally chided him by saying that he could not just keep getting in and out of the line and that I finally took him into my arms and said simply "don't worry...there are no words" and walked him to the casket so he could say his good-bye.  He shared that he had never been able to express how deeply David's death had affected him and that he thought of him every morning when he looked at the tattoo he'd had done in his memory.  We talked for an hour and at the end agreed that it was only the beginning of many more conversations.   

I often speak of the many truths I have learned from David's death. One of them is that people who suffer from the disease of addiction often defend their actions by proclaiming over and over that it is a personal choice they make to abuse drugs and alcohol, that it their right to do so and that their actions affect no one other than themselves.  Of course they are wrong..their choices affect those they are closet to and who they love the most.  And when they run out of time, like Dave did, it affects their friends and loved ones forever.   

When I hung up the phone that morning not so long ago I also marveled at one of the other unspoken truths which I have known in my heart for a long time, that so many of David's friends still hold his memory as a great treasure just as we do. 

Hawk Walk 2008 First Steps For Recovery

This past weekend was our 3rd Annual Hawk Walk First Steps For Recovery 5K family fun walk the proceeds of which go to support The 24 Group, a not for profit foundation that provides support to families whose children struggle with addiction.  To promote participation in the event my sister-in-law Sheila sent the following email to her colleagues at the Community North Emergency Room where she has worked for many years and where ironically our son (her nephew) died in June of 2001.

She has given me permission to share with you her note which not only allows me to thank publicly many of the staff who tried so valiantly to save David's life that bright warm day but at the same time share a few intimate details of David's last days that his mother and I were not aware of until we read this note.

From: Sheila 
Sent: Saturday, October 04, 2008
To: Emergency Room Staff
Subject: Please take a moment to read

Hi.  I am not one who normally asks for donations or anyone to help with school fund-raisers, but I am involved in a project that is near and dear to my heart.  I am asking you to take a moment to read this.

On June 9, 2001 my nephew David was with friends at a backyard pool.  As many teens often times do, David thought he was invincible and able to try anything and still be ok.  David and his friends were huffing a can of aerosol keyboard cleaner.  He went into cardiac arrest and drowned.  The medics were called and he was brought into Community Hospital North ER.   Two of Lawrence Townships best medics (Jeff Wayne and Steve Stanley) were at the scene.  The ER staff that day were the best the department had to offer (Dr Hale, Dr Eshelman, Kathy Guise, Pat Myers, Rose Emerson, Kelly Jenkins and many more that my mind just can't remember).  Still David was too far gone and pronounced dead at 3pm. 

Ironically  David was supposed to be a summer volunteer in the ER that year.  One week earlier I brought David to ER with me to take a tour.  He was so excited to start working here and was particularly intrigued by the shock rooms.  In fact, when we stopped in Shock Room 1, he said he could tell he wanted to spend a lot of time in there.  One week later, he died in that room. 

David came from a loving home, parents were supportive, educated and very involved in their son's lives and friends.  Still, he made choices that were risky and took his life.  Needless to say, this was very devastating to my sister, to me and my entire family. 

Since his death, my sister and brother in law have become very active in educating other parents about drug abuse and warning signs.  They have formed a group called The 24 Group which supports families whose children struggle with addiction and funds drug education and awareness programs.  One of the fund raising projects is a Hawk Walk which takes place on Saturday Oct 11. 

I have posters in the break room and locker rooms in ER as well as flyers in a few mailboxes about the annual HawkWallk.  If you are free on the morning of the 11th, please come join us for a 5K.  If not and you are able to make a small contribution to The 24 Group, that would be awesome.  Mostly, please remember my family in your prayers.  I would like to think that David's death did not occur uselessly.  Hopefully his story will benefit others who face the dilemma of teenage drug abuse. 

Thank you,  Sheila

If you are interested, you can log onto www.The24Group.org and read about what the group does.  There is also a blog written by my brother in law Kim Manlove about his struggles to cope after his son's death.  Warning - have a box of Kleenex by your side - it's quite the tear jerker.  Also if you are in Chicago and at Navy Pier, there is a display about drugs and my nephew is one of the featured stories.

Methamphetamine And The Wack A Mole Theory

Politicians and criminal justice types don't have to look very far today to be reminded that the Methamphetamine gravy train has long since left the station.  By 2005 only 10 States had not enacted precursor laws which, by controlling access to the pharmaceutical ingredients of meth, essentially knocked the legs out from under the home grown Meth Lab business across the country.  Lab seizures plummeted yet law enforcement officials, county, state and national politicians have continued to insist that meth was their highest priority despite a mounting body of evidence to the contrary. 

There is no question that methamphetamine is one, if not the most, highly addictive and potentially lethal substance being abused today.  Treatment professionals often privately say that while it is routine for men and women in their 70s and 80s to seek treatment for alcohol, prescription drug and even cocaine addiction, they are not likely to see methamphetamine addicts become senior citizens because they will be dead! 

It is also true that it is unlikely we will ever totally eradicate the use of any illegal substance that is abused and that there is also some truth to the "wack a mole" theory of drug prevention that as one substance is targeted and declines another escalates.  Indeed the "wack a mole" theory may be in play given the resurgence of heroin across the country as well as the alarming rate RX/OTC abuse nationwide that is now challenging marijuana for the top-spot in illicit drug abuse nationwide.

It is time for law enforcement officials and politicians to bring some balance to their prevention efforts and abandon their habit of demonizing a single substance while the rest of the moles get out of wack!!!!

A Miracle of Recovery

I had my first taste of alcohol when I was 15.  The locale was exotic even for a teenager.  My father, a university professor, was on sabbatical and we were living in England.  For Christmas that year my parents decided to leave the cold damp misty isles of Britain for the warm and sunny Mediterranean.  Their choice was the balmy beaches of  the Balearic island of Majorca and we eagerly packed our bags leaving the cold and dismal clime of London behind.  It was an idyllic week of sun and sand mixed with an occasional dose of castles, cathedrals and ancient Spanish history.  Our stay coincided with bringing in the new year in Palma the capital of the island chain where the Moorish influence hung heavy in the air.  On New Years Eve the hotel where we were staying hosted the obligatory bash and the champagne flowed like water.  I was 15 at the time soon to be 16 a scant 5 weeks hence.  My mother and father, teetotalers in their young adult years and now social drinkers, made a conscious decision to allow me and my year younger sister to partake of the festivities including the champagne.  They were both well educated and meaning parents who felt that the special circumstances and exotic location warranted some relaxation of their usual strict parental supervision and I could not have been more grateful at the time.

I still remember that first taste of champagne as it bubbled over my lips, the effervescence tingling in my mouth and throat, the warmth that spread throughout my body and the sense of well being that permeated my soul.  From that day forward and for the next 35+ years I chased that same feeling from drink to drink and drug to drug always striving, but never quite achieving the first wondrous feeling on that New Years Eve, 4500 miles from home and four decades past.

High school, college and graduate school saw my substance abuse grow in regularity and diversification as I added more and different kinds of drugs to the alcohol.  By young adulthood I was aware, as were those close to me, that I had some difficulty in controlling my use.  However the legal consequence that some of my friends experienced and which I equated with "problem drinking and drug use" never seemed to happen to me.  I would have occasional lapses of drunkenness which would be followed by periods of enforced sobriety, promises of stopping or attempts to control my drinking by changing from liquor to wine to beer.  But the result was always the same.  When our first son was born I vowed to stop drinking to excess which only resulted in my beginning to lie about my drinking and to hide it.  I became a closet drinker and at some point...which I can't remember...I became a closet alcoholic and occasional drug user.

I continued my clandestine career as an alcoholic as our boys grew into adolescence and when our youngest son David developed a serious problem with alcohol and marijuana at the age of 15 there was no denying that he was his father's son.  His death 11 months later in a substance abuse related drowning was a tragic example of the rapid progression of the disease of addiction in spite all his Mother and I tried to do to prevent it.

After he died...I came out of the closet.  I had never really needed an excuse to drink and drug but now I had a really good one.  No one was surprised by my drinking and even my therapist characterized my increased usage as understandable "self-medication".  What no one knew at the time was that I had jumped back into the bottle with both feet which seemed to be the only way I could make the noise in my head of grief, guilt and anger go away...if only for a little while.  Of course, as all alcoholics know, it only made it go away for a short while, and as the weeks turned in to months it took more and more to make it go away for a time that grew less and less.  I became a increasingly dysfunctional alcoholic until two years after David's death I dropped all the balls I had been juggling for so long and entered treatment at Fairbanks Hospital, the same facility he had attended.

Next week will be the fifth anniversary of the beginning of my recovery from alcoholism, a recovery that begins anew every morning.  I have come to believe many new truths, have received many gifts and have witnessed many miracles in recovery.  I never believed in miracles before because I really didn't believe in God.  But in recovery I have found a higher power and today I do believe in miracles.  When I was just out of treatment I was required to go to "aftercare" a weekly meeting of 35 to 40 alcoholics and addicts.  The counselor who ran the group was a crusty old codger in his late 70s.   He had more than 20 years of sobriety but his years of drinking had taken a heavy toll making look every bit of a 90 year old.  He was full of all that Alcoholics Anonymous wisdom stuff, knew all the sayings and spouted them continuously throughout his weekly meeting.  I didn't like him very much in the beginning because he had a way of reading our files and then calling us out when we said something he took exception to.  I had successfully stayed out of his way and thought I was off his radar screen until one night after I had been in his group for six or seven weeks. 

I don't remember what I said that night but he brought me up short and called me out in front of the entire gathering.  He said "Kim, I've read your file and I know what happened to you...and I want you to know that I believe that when an addict or an alcoholic dies they buy sobriety for someone else.  I think that is what your son did for you."  I hated him for saying that to me that night.  Hated him because I didn't believe it and I didn't want to believe it.  But five years later I do believe it and I have accepted that gift from my son David.  And that journey from the anger I felt that evening five years ago to the acceptance I have today....is a miracle.  A miracle of recovery from my son David. 

A&E's Intervention and Inhalants

Intervention on A&E has consistently offered a honest and often stark view of the disease of addiction and continues to distinguish itself as the only true "reality" show on television today.  While many of the segments have hit close to home for me the most recent episode is especially compelling and poignant in that it deals with the substance and practice that killed my son David.  "Huffing", the intentional inhaling of propellant chemicals contained in aerosol cans is an addictive and potentially deadly practice profiled this week by Intervention. 

In the years since David's death I have written and spoken about the tragic consequences of "huffing" to thousands of young people and their parents.  In working with several national advocacy organizations on inhalant abuse I have always tried to adhere to their basic tenant of "do no harm" by refraining from showing how to use inhalants while telling the story of David's death.  This week Intervention tells the story of Allison, a young pre-med student addicted to inhalants, using up to 10 cans of computer duster a day and spiraling down into insanity.  It is a brutal depiction of the extreme effects of a young woman in the advanced stages of addiction to inhalants and near death.  During the course of the show there are numerous scenes of Allison inhaling duster shown in great detail that leaves nothing to the imagination. 

Despite these graphic scenes, which inhalant abuse awareness advocates may feel violate the "do no harm tenant, I strongly support and applaud A&E for their bold portrayal of this subject.  In today's culture where one need only search My Space, Face Book and You Tube to find hundreds of references and videos of young people using inhalants recreationally in a callous manner without fear of the lethal consequences.  It is laudatory of A&E to address Inhalant Abuse in a manner that leaves no doubt about this dangerous and potentially tragic practice that can cause death with "every breath you take." 

Drug Testing and Teens

7 Reasons Parents Should Not Test Kids for Drug Use