Pubdate: Wed, 02 Aug 2006
Source: St. Paul Pioneer Press (MN)
Copyright: 2006 St. Paul Pioneer Press
Contact:  http://www.twincities.com/
Details: http://www.mapinc.org/media/379
Author: Thom Forbes, Public Access Journalism
Note: Thom Forbes is an author, blogger on addiction and recovery, 
and former reporter for the New York Daily News.
Bookmark: http://www.mapinc.org/pot.htm (Cannabis)
Bookmark: http://www.mapinc.org/coke.htm (Cocaine)
Bookmark: http://www.mapinc.org/find?159 (Drug Courts)
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)
Bookmark: http://www.mapinc.org/find?143 (Hepatitis)
Bookmark: http://www.mapinc.org/heroin.htm (Heroin)
Bookmark: http://www.mapinc.org/find?136 (Methadone)
Bookmark: http://www.mapinc.org/rehab.htm (Treatment)

ADDICTION FROM BOTTOM TO TOP (PART 1 OF 5)

A Family's Generational Struggle To Live With Addictions

I am, at the least, a fourth-generation alcoholic. So is my wife, 
Deirdre. Our 22-year-old-daughter, Carrick, is a recovering heroin addict.

Most members of our family have been successful professionally - 
Deirdre's father was an attorney and judge; my side brims with 
journalists who kept the proverbial pint flask in their desk drawers.

My great-grandfather was run over by a trolley car while covering a 
story in 1904 - still reporting, probably inebriated, but certainly a 
broken man who was estranged from his family. Many of his progeny 
shared his taste not only for booze but also for the illusory 
camaraderie that goes with it in bars and binges.

Most of us got sober, but we've taken different routes to get there. 
I've learned along the way that there is a difference between not 
using a drug and being in recovery, which encompasses the way you 
lead your life, interact with other people and face your mortality.

To greater and lesser degrees, we functioned despite our illnesses, 
as many of you, or your loved ones, do today. More than 22 million of 
us older than 12 abuse or are dependent on alcohol or illegal drugs, 
according to 2004 government figures, and that's not counting 
prescription drug misuse, a rising crisis. Sixty-three percent of 
Americans say that addiction - their own or another's - has had an 
impact on their lives.

Going Dry

I first swore off booze as a 16-year-old who'd stop off in a saloon 
on the way home from high school for a few boilermakers - shots of 
bourbon chased by a beer. That period of sobriety lasted a few weeks; 
relapse is part of this disease.

I had my last drink two decades ago, when I was 32. My bottom came 
when I discovered the liquor cabinet was dry one evening. With my 
toddler tugging on my leg for attention, I felt physically compelled 
to buy a bottle of vodka, spiritually driven to stop letting alcohol 
control my life, and intellectually determined to end the cycle of 
waking up with a hangover, nipping at lunch to feel "normal," 
imbibing in the evening to get blotto and arising again with a hangover.

Few of my friends thought I had a problem; most drank as much as I 
did. My best buddy from those days, prone to depression and Seagram's 
7, blew his brains out 10 years ago, still drinking.

I did not seek treatment or help from a 12-Step program like 
Alcoholic Anonymous because I was not comfortable turning over my 
life to a "higher power."

Whenever someone asks me how to get sober, however, my first 
recommendation is to head to the nearest 12-Step meeting. Deirdre 
did, and the fellowship she found "in the rooms" was the cornerstone 
of her recovery 19 years ago - and counting.

You're always counting, because sobriety is, as the AA slogan goes, 
"one day at a time." The reality is that I picked up a lot of the 
12-Step philosophy by osmosis, and its precepts have helped not only 
the millions who join but countless others who are "sick and tired of 
being sick and tired."

Every treatment philosophy has its zealots, from 12-Steppers to 
members of therapeutic communities such as Phoenix House that break 
you down in order to build you up. Any of them may work for you. Some 
will tell you that their way is the only way. That's true only to the 
extent that it's true for them. The bottom line is that many people 
overcome their addiction and flourish, but less than 10 percent of 
people who need intensive treatment at a substance abuse facility 
actually receive it in a given year, according to the federal 
Substance Abuse & Mental Health Services Administration.

A New Issue

Deirdre and I had our own ideas about what would work for our 
daughter, Carrick, who first drank at 12, smoked marijuana at 13, 
dabbled in other recreational drugs by 15, became a heroin addict at 
17 and met her bottom while speedballing - mixing heroin and cocaine 
- - at 19. By that time, she had been through three emergency rooms, 
seven detoxes, three short-term residential programs, a four-month 
wilderness therapy program, several 12-step programs, four special 
schools and had prematurely quit a long-term treatment community 
twice. She had talked to dozens of psychiatrists, psychologists, 
social workers, medical doctors and addiction counselors. The deeper 
her addiction took hold, the better she got at telling them all what 
they wanted to hear.

After she turned 16, Carrick was often away from home. When she'd 
visit our suburban New York State home, she recently recalled, "I 
would come home with a warm greeting, pillage the house and leave 
with a warm farewell. It was not just stealing money, but time, sleep 
and sanity."

We eventually told Carrick that we would no longer enable her in her 
addiction - including providing shelter and food - while she was 
using drugs, but we would do anything we humanly could to help her in 
her recovery. Some people feel that barring our daughter from our 
home was heartless. We knew her life was at risk every day she was on 
the streets of New York City, but she proved time and again that she 
would not face her recovery as long as we protected her from her 
bottom. Nor was it fair to our son, Duncan, five years younger. Or ourselves.

In the end, Carrick decided, on her own, to try methadone 
maintenance, a controversial treatment that critics contend 
"substitutes one drug for another." It saved our daughter's life. She 
is gradually reducing her dosage with the intention of quitting; 
others may need to stay on methadone all of their lives. Many become 
productive members of society, no longer scheming for the next fix.

"You've got to meet addicted individuals on their own terms rather 
than confront them on yours," says Dr. Harris B. Stratyner, clinical 
division director of Addiction/Recovery Services for the Mount Sinai 
Medical Center in New York. "The goal is to get people to completely 
stop using, but not to say to them, 'You're using, therefore I'm not 
going to engage you in treatment.' That's not the way you motivate someone."

Stratyner is a leading proponent of a "carefrontation" model of 
treatment, which holds that addicted individuals should not be held 
responsible for having their disease any more than diabetics are, but 
must take responsibility for their recoveries. So must the family and 
friends who get caught in the vortex of lies and manipulations that 
swirl around an addicted person.

It's human nature to want to believe a child or spouse who tells you 
"this is the last time," no matter how often you've been burned 
already. At times, Deirdre and I enabled Carrick to continue using 
without facing repercussions - for example, by making excuses for her 
behavior to friends and teachers.

One day, I found a hypodermic needle and a card that allowed Carrick 
to exchange it for a clean one. My instinct was to break the needle 
and rip up the card. But what would that have accomplished? Dirty 
needles spread hepatitis C, which Carrick has contracted, and HIV. 
Shuddering, I chose the lesser of two evils, a misunderstood concept 
known as "harm reduction," and put the paraphernalia back.

Some say that it's fruitless to force a person into treatment, 
particularly a teenager who is still enjoying the dopamine-induced 
good feelings that drugs undeniably provide. More than 80 percent of 
teens relapse within a year of treatment, according to one study. 
Carrick will tell you, however, that she took away one very powerful 
idea from the programs she attended and prematurely left: When she 
was ready, she could get better. And once she tried, we again did 
everything we could to help.

"Without trying to sound melodramatic, giving me another chance 
probably saved my life," Carrick says. "The line between enabling and 
supporting sometimes requires you to take a risk and hold onto realistic hope."

Call it paternalistic - in my case it literally was - but addicts 
frequently don't know what's best for them and interventions may be 
necessary. When Carrick was living on the streets, we prayed that she 
would be arrested and mandated to treatment by a judge. When she was 
finally nabbed for theft, however, she was sentenced to 30 days in 
jail. She celebrated her release by getting high.

Drug courts around the nation are beginning to substitute treatment 
for incarceration for nonviolent offenders. About 80 percent of the 
more than 2 million teens in the juvenile justice system have drug 
and alcohol problems, according to figures compiled by the Robert 
Wood Johnson Foundation, and a similar percentage have diagnosable 
mental illnesses.

Indeed, addicted individuals of all ages who suffer from illnesses 
such as bipolar disorder may use mind-altering drugs to self 
medicate. We once begged the admitting doctor at a psychiatric 
hospital to treat Carrick's underlying depression. We were devastated 
when he not only gave us the party line that Carrick would first have 
to abstain from drugs, but also expressed his doubt, based on her 
record, that she'd be able to do so.

She has, though, and is attending college with the intention of 
becoming a fifth-generation journalist. An antidepressant stabilizes 
her mentally; she says she no longer "gets in a crummy mood for no 
apparent reason."

A High Price

In 1998, more than 10 years after she got sober, my wife Deirdre 
became so deeply depressed and suicidal that I marked her survival 
from hour to hour. She eventually signed herself into New York 
Hospital-Cornell Medical Center, a psychiatric hospital in White 
Plains, N.Y. Her life was saved by electro-convulsive therapy, 
antidepressants and talk therapy. She has gone on to become an 
accomplished substance abuse advocate and professional, working as an 
intake coordinator for Madison East, a unit within New York's Mt. 
Sinai Medical Center. She's a happy and productive wife, mother and citizen.

Fortunately, we've been able to afford treatment for her and Carrick 
over the years, but because New York State lacks a parity law for 
mental health and substance abuse, insurance coverage has been 
erratic and spotty. We've broken into retirement IRAs and refinanced 
our mortgage to pay medical bills.

What's most unfortunate to many of us on the front line - addicts and 
family members - is that the war on drugs has become a polarized 
battle between two camps: hardliners whose "zero tolerance" approach 
relies on interdiction and prisons for illegal drugs and 
laissez-faire libertarians and reformers who believe that supply, 
demand and individual choice should allow the market to reach its 
natural level.

The market for mind-altering drugs is a lucrative one, indeed. They 
are responsible for the livelihoods, legal and illegal, of millions 
of people worldwide - from drug lords to rapid detox clinicians, from 
bartenders to prison guards, from bureaucrats to copywriters. A 
recent study by researchers at the University of Connecticut 
confirmed that the more alcohol ads teens see, the more they drink. 
But the alcohol industry has the economic muscle to protect its 
interests: The beer industry in the United States alone spends $1.36 
billion in measured advertising dollars annually, employs 1.78 
million people, pays $54 billion in wages and benefits, and generates 
$30 billion in taxes.

The money for treatment is harder to come by. The Bush 
administration's $12.7 billon drug control budget request for 2007 
earmarks 65 percent for interdiction and law enforcement and barely 
36 percent for treatment and prevention. A National Center for 
Addiction and Substance Abuse report found that of the $277 each 
American paid in state taxes to deal with substance abuse and 
addiction in 1998, only $10 went toward treatment and prevention.

There is an obvious common ground: People. If we were to focus our 
efforts on the family members, friends and neighbors whose brain 
chemistry has been altered by drugs and alcohol, and treat abuse and 
dependency as the public health scourge that it is, we'll have 
declared a war on addiction.

It's a campaign that can be won, one life at a time. I've seen it happen.
- ---
MAP posted-by: Beth Wehrman