I have heard it all. Kick her out, tell her no, don’t help her, make her struggle; only when she is desperate she will seek help. Part of me buys into this school of thought, and then there is this piece of me that thinks, why does it have to be so bad before it can get better? With anyone whom I have had this conversation I have been told that it is because I see through mothers eyes and mothers guilt that I am fighting it. I don’t want to see her struggle so I let her walk all over me and my family. Ok, I agree that might be true. But it also feels like it is against my will as a human to make someone be at the absolute lowest point in their life and turn your back on them.  I don’t believe that can possibly be the best practice. Aren’t addicts already suffering? Aren’t they already tortured with low self-esteem and self-loathing? Why do we need them to be lower than that before they can get help?

The whole process is so wacked out, if you ask my opinion.  If you’re sick, dope sick, and need to get into detox, you have to have used within a certain period of time. You might not be sick enough or high enough or used enough for detox to help. I have spoken to many healthcare professionals whom I told that I detoxed her at home but she needs after care. They suggested I get her drugs so she can use so she can get into a program because it’s impossible to get into a program from the street. Say that again? Let her use?  Oh but it gets better. To even get into a detox we have to pass the face-less, name-less test. Someone on the phone, at the insurance company, who knows really nothing about the person you are, or your situation, whom is only interested in how many bags you use, how you use it and how many times you have tried recovery before, makes a decision on whether you are eligible for detox. And sometimes they say no. No because you have no willingness. Oh..hmmm.. Ok let me just make sure I understand this correctly. If I was clinically depressed, and I tried to commit suicide, I would be hospitalized. I would be given prime physical and mental health care, and in the event that I tried to commit suicide while in the facility, I would be given more care, more attention, more help. I would not be thrown out because I didn’t have willingness to live. I would be given more chance to determine that I have value and should want to live, and help myself. I would be given the opportunity to learn the appropriate response to the negative feelings I have by way of group meetings, independent therapy, medication if necessary and guidance on better decision making.

If I am an addict, and I got to detox/dual diagnosis unit and I use on the unit, I am thrown out. And denied further coverage until I have a willingness to help myself.  How does that make sense?  Addiction is a brain disease. The American Medical Association labeled addiction as a chronic, progressive and possibly deadly disease, if left untreated. Yet we treat it like a social stigma.  Health Insurances tie the hands of the patient and families and really, the medical professionals who know the patient needs more treatment but is not authorized to give it. When JoDee first went to detox she was on Harvard Pilgrim through my ex-husband (#2, why I have two ex-husbands is a post for another day, and a different blog!) and was able to get into a good detox program. Of course she wasn’t completely ready, and let’s face it, 7 days in detox is nothing, which at the time I did not know. Back then, Denial was my partner, so when I picked her up from rehab I thought that was over and I wouldn’t have to worry anymore. No one prepares you. There is this whole part of the healthcare that is ridiculous. JoDee was 18. Not a child. Not a minor. They wouldn’t talk to me. They didn’t have a family meeting and say this is what you need to do to protect your kid. The discharge meeting was in the hallway, with a nurse and JoDee, JoDee’s belongings all packed right there, and it consisted of her handing me some prescriptions and saying she couldn’t say much but JoDee needed them filled. JoDee even said can you talk to my mom because I don’t even remember what you told me. The nurse told JoDee she was an adult and needed to take responsibility and with that we were ushered out the door, so the addict waiting outside, could take her bed. Simple as that. I was still in shock. I’m still in shock, but I know now that I don’t have time to be in shock. And I also know that the system is ridiculously broken. Sitting in the ER with JoDee numerous times, I saw people playing the game. I see why the ER staff is so cynical. There are people who came in feigning illness seeking drugs, there were people coming in claiming the desire for help only to sleep it off, in a warm bed for the night, and check themselves out in the morning. There were people like JoDee who had willingness and their resolve breaks, which bring them back again and again.

The biggest problem with addiction, I mean aside from the obvious, i.e., ruining lives, killing people, etc, is that it’s so cunning. Someone who has diabetes and eats cake, pies and chocolate bars, things that can decidedly kill them, is not judged or withheld from treatment. They are not told, don’t eat candy and it will get better. They are treated as sick patients. Given social services help, follow up treatment, education. Society, and the Medical world at large, does not give up on them.  I am not comparing illness, in fact, the opposite. I am pointing out that one disease IS NOT worse than the other, or any less controllable. Let’s go over this again. Addiction is a brain disease. It is not a choice. At some point, an addict has to work at his/r own recovery, no different than someone with a heart condition must pay attention to what they eat, how they eat, getting exercise, etc. When someone gets lung cancer from smoking 2 packs of Camel Non-filtered cigarettes for 50 years, we think it’s a horrendous shame. And we even get upset when they don’t quit smoking. But we don’t stop medical treatment. We don’t tell them to come back for treatment when they have willingness. And we certainly don’t make them be homeless, hopeless, family-less and alone in the gutter before we can help them.  It does not make sense to me, not as a mother or as a fellow human being that we should make mentally ill individuals suffer even more.

Don’t get me wrong. I am not saying open your wallet, give them the license to use and abuse until they die or come to their sense because that makes no sense either. I just think the expression you catch more bees with honey than you do with vinegar really resonates here. Why can’t we love them until we can help them? Shouldn’t there be a way to keep leading the horse to water until he is thirsty enough to drink? I get the premise behind tough love and I can tell you first hand, it works to some degree. But there is also a point when an addict in active addiction will do anything, and I mean anything, to get the drugs they need.  I say need because there is an astounding distinction between wanting something and needing something.  To understand addiction, truly understand it, and then you will know the difference is a need not a want. That isn’t to say that addicts aren’t self-centered and entitled and a whole host of other things that makes them frustrating. Believe me I understand that they are. I’m sure there are addicts that could read this and say I’m out of my mind. Or maybe some will agree. Either way, I believe the system is gravely broken. Drug court has its merits, and is a savior to some, but is a huge burden on the tax dollar. Imagine the money the government would save on drug related crimes if our addicts were given better chances of recovery with government support instead of government punishment? At the moment, we don’t have socialized medicine; however, if I were under the poverty level, or threw JoDee out of the house, or even as willing to lie and let her say she was homeless, she could get Mass Health, which will pay for the $30k a month rehab in a long term, inpatient facility. But, my Tufts Health Plan, that I pay for, or JoDee’s dad pays for (we both have Tufts at our individual employers) will only pay for 7 days of detox (and JoDee has to keep saying she is suicidal to get the extra days), an IOP treatment that is affiliated with her PCP hospital, and doesn’t have a great success rate because it’s run by people who read about addiction but have never actually experienced it, and no aftercare other than individual therapy. No other inpatient program. Ever. For the life of her coverage. But alas! They do offer an alternative. Outpatient drug therapy. She can go on Suboxone or methadone (and the success rates that I have read from different resources are mixed when the addict has used drugs intravenously) and insurance will cover her to receive her daily dose of suboxone or methadone every day. For an undetermined amount of time. I believe Suboxone/Methadone may be the answer for some. I believe it may not be the answer for others. There are other alternatives: Vivatrol, Abzolv, and a few other new ones popping up on the market.   I have spoken to many psychiatrists along JoDee’s travels, and they all feel the same way, JoDee is at a huge risk of fatal overdose by using anything that would be considered an opiate blocker because she would try to use to break through it. She has proven that she will use until she literally is unable to function as it is. Given all that info, you would think, an educated, medical professional would think that maybe this kid needs help greater than a pill every day and outpatient therapy. Not Tufts.  Tufts says Leland/Bayridge and that’s it. Except the Methadone/Suboxone clinic. You can get that as much as you want. I actually called Tufts myself and spoke to many, many people. I kept asking for another manager or someone hirer than the person I was speaking too so I could plead my case. Even get JoDee two weeks somewhere, it would give me a chance to figure out what to do next. And I was basically told that addiction is a social issue, not a medical condition and that insurance was under no obligation to continue treatment. At one point, the nurse on the phone told me that I wanted her recovery more than she did (which in essence was probably true, but isn’t that true for ALL addicts until they truly find recovery?) It’s my experience that every addict wants recovery at some point, even if it’s for a fleeting moment, and then addiction/craving/mental illness take over and the moment is gone. I believe there must be a better way to help them into recovery, to support the disease without supporting the addiction until the patient can save themselves, or participant in the process. I hear at NA meetings that it ends three ways: Jail, Institutions or Death and not necessarily in that order.

Shouldn’t it be our goal as a society to make that be more about Institutions, Support, and Services so there are less Jail and Death? I am so confused by the messages I hear.

1. It’s not my fault that she is an addict. There is nothing I could do to stop or prevent it.
2. Be strong. Use tough love. Support recovery not addiction.
3. Addiction is a brain disease. It’s a medical and psychological problem.
4. Addicts are responsible for their actions.
5. Addiction is a life long struggle.
6. Addicts need to help themselves. Do not trust them. Do not help them.

 

If it is a life long struggle, if it is a brain disease, why are we not treating the source of the addiction differently? Why are we not rewarding positive behavior? Teaching behavior modification? Why is there not more money spent on research and new programs to help with prevention and better recovery? There are limited options and the options are really for those either basically homeless to get on Medicaid or those that extremely rich to pay privately.  I don’t believe her addiction is not at all my fault. I am her mother. She began using at a very young age. There is a reason behind that. I want JoDee to succeed in life. I know that Reality is giving me that look, the you-are-so-naive look but the truth is the statistics don’t lie. Our loved ones are dropping like flies from addiction and addictive behavior. As a whole we need to come together to find a new way to help those that can’t help themselves. We need to learn that if we are saying it is a disease it needs to be treated like one. We need to learn that doing the same thing over and over and expecting different results is INSANE. We need to stop the madness saying in one breath addiction is a struggle and then treat an addict like a parasite. As 2014 comes to an end, I know that for the next year I will bring awareness to the true struggles of addiction. It’s time for some change.