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Sister of Heroin

Life & Thoughts of a Heroin User's Sister

What a Year!

purple martin

It’s been a while since I’ve taken the time to process things, but today is special to me.  I remember what I was doing exactly one year ago…

It was a beautiful summer evening.  I had surprised my love by taking him to a Purple Martin party hosted by the Audubon Society.  Every year hundreds of thousands of purple martins fly in to roost in a small group of trees right around sunset in July in Austin.  The sky darkens with the sheer density of the creatures and people gather to watch in awe.  My love has a phobia of birds, so this was an interesting surprise for him, but he handled it well.  Following the spectacle of things, we went to a nearby hotel where they were offering a Purple Martin martini special.

While we were sipping our drinks, I got the text message from my brother letting me know that he was at the hospital and asking me to buy him some food.  Reaching out to me on that day was the beginning of a long series of events that brought my brother into recovery.

While I can’t say that things always went smoothly from that day forward, I can say that my brother has over six months of sobriety now.  He’s living with roommates, working, and attends meetings with his fellow rehab alumni.  I sent him a message today to let him know how proud I am that he reached out a year ago and began to change his life.  We have been so blessed for things to have changed so much in the past year and I am so grateful for today.

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It’s the Families that Pay

It’s been about a month since my brother was released from rehab.  Let’s recap the financials.

3 months of inpatient rehab – $30,000

Defense attorney – $3,000

Sober house deposit – $250

Six weeks rent for sober house – $1,000

Food for my brother – $150

Bus ticket to court assigned community service – $30

Drug test for brother’s new job – $25

Various mileage costs transporting my brother to job interviews, court appointments, community service, etc. – $150

So far, this has been the hard cost to my family to get my brother clean from his heroin habit. This is in addition to the amount of time that each one of us continues to contribute to help ensure his success.

My mother and I have discussed more than once how obvious it has become to us why people with addiction would end up incarcerated and/or homeless.  Helping someone get clean is both a financial and emotional drain.  When a court system punishes an addict, they are really punishing the whole family.  That is, at least, families who have not completely disowned the addict due to their behaviors.

My parents may never retire after this round of treatment.  They only have about a decade left to save, and at the very least this has put a significant dent into the savings that either one of them had.  If there’s ever a relapse, I’m not sure that we would be able to help again even if we wanted to.

Addiction treatment is a multi-billion dollar industry in this country. In the end, it’s the families who pay…with their money and sometimes with their children’s lives.

Sober House

My brother said that he was a celebrity at the rehab.  In a world where many people go through 30-day inpatient treatment programs, my brother had been at his rehab for a full 90-days.  He had been given special responsibilities to help new guys adjust to the program, but nevertheless he was really excited to leave.

It was a windy day when my mom and I picked him up.  He didn’t have many things so we took him to a Walmart for essentials before dropping him off at the sober house.  Last time Joseph did rehab, he was supposed to exit into a sober house but the rehab had been unable to help him find one to move into.  My brother had lasted only a week before he disappeared back into his drug lifestyle.

This time around this different rehab had found my brother a spot at a sober house.  In fact, this sober house is located in a neighborhood that I had moved out of eight years earlier because I couldn’t afford the rent anymore.  His new $800/month location is certainly not cheap, but clearly it’s a nice neighborhood and there are lots of businesses in walking distance.

Joseph was especially excited to move into the new place because he would be rooming with someone that he had befriended at the rehab.  I’m glad that he will be starting with some kind of support system in place.  The sober house has pretty stringent rules about attending AA/NA/HA, etc. meetings and working or volunteering, but I think that it’s a good thing for the residents.

Joseph has been there about a week now.  I took him a couple of packs of cigarettes today and bought him a quick lunch.  He’s still making eye contract, still responding to text messages, and is actively looking for work.  His jittery nature made me feel a bit concerned, but I know these guys chug coffee and energy drinks like there is no end in site so I tried to dismiss it.  Joseph’s court date is Monday and if all goes well, his probation will be reinstated and he’ll spend his next six months in the sober house.  It’s a relief to have my brother staying on his own, but scary too.  I’m just glad he’s not far away.  If he could just get a job now, things would dramatically improve for the family.  After the cost of rehab, $800/month plus food and cigarettes cost continue to be a drain.

We pay it all because having him around and not on drugs is worth it and we’re feeling relieved for now that all is well.

Intrusion

While I was away on my honeymoon, my dad had a counseling session with my brother. Apparently it did not go well. When I asked my dad about it, he launched into a tirade of complaints largely consisting of, “Fuck that rehab.” My dad has got it into his head that he will create a new business, and following my brother’s exit from rehab, he will teach my brother the trade. He does not care if that’s what my brother wants to do or if his plan is not in line with the plans my brother is developing with the rehab staff. He is stubbornly adamant that the only possible way to keep my brother sober is to have him under constant surveillance while teaching him how to run a business. When my brother’s counselor shared my brother’s plans with my dad and mentioned that starting a business fresh out of rehab was probably not the best plan, my dad immediately attributed this to the rehab’s “12-step bullshit.”

My brother called me yesterday and I informed him that our father was intending to write him a letter saying something along the lines of, “I’m sorry that I could not afford to get you into a non-12-step rehab and that they are forcing you to develop all of these bullshit plans. Because I paid for your rehab, you are obligated to come work with me to pay me back.” My brother already has his fair share of issues with my dad. He just started speaking to him again within the last six months. As you can imagine, he is not keen on the idea of being under my dad’s overbearing direction.

As we were talking about this, my brother seemed down…more so than usual. When I started asking how he was doing, all of a sudden his counselor jumped on the phone. Without my knowing, she had been quietly listening to the whole situation. The counselor wanted to tell me that during the session between my brother and our father, my dad’s own history of substance abuse issues came up. Unsurprisingly he had disregarded this as any kind of attributing factor to my brother’s issues and responded very negatively to any suggestions that he himself receive counseling.

Thanks for that perspective, but what the fuck? I felt so intruded on and personally violated by finding out that what I had believed to be a personal conversation with my brother was actually some sort of covert information gathering attempt by my brother’s counselor. I think my dad’s perspective of “fuck that rehab” is a little extreme, but seriously fuck that counselor.

My Wedding Day

Yesterday was my wedding day. We had the wedding in Puerto Rico and had planned for the event for months. The hardest part of planning was dealing with the emotions. When my fiancé and I first picked out the wedding location, we were excited. We wanted a small wedding and we thought that having a destination wedding would naturally limit the number of guests. We also chose the location so my fiancé’s father, who lives in Puerto Rico, could easily attend. I was thrilled to tell my family about my wedding plans. When I told my grandmother, her response was “No one wants to spend money to go to your wedding. Everyone has already spent everything on your brother. You’re being selfish.”

She was referring to my brother’s rehab expenses and her words cut me deep. I spent so much time just wanting to cancel my wedding, elope, and spare my family any further burden. There were many following conversations with my parents about how I needed to do what would make me happy on my wedding day. I felt like I would be just as happy eloping, but it became clear that my parents really wanted to be present for the event.

As it turns out, my brother ended up being back in rehab again on my wedding day. My grandmother asked where he was, but didn’t seem to understand my response.

He called me today not even knowing that the wedding had already taken place. He gave me the usual congratulations, but in the end the conversation ended with him asking for yet another favor. He had run out of cigarettes and wanted me to ask our parents to get him some. He could have called them, but he’s still avoiding that type of communication.

I’m glad he called me and I’m glad he’s doing well. I had a great wedding and, while I did miss him, he hasn’t been present for family events for years so things still felt natural. I hope that one more month of rehab will put him in a place where he can think more about others and not just about himself. In the meantime, here’s to marriage and life going on even when things aren’t perfect.

Things are Looking Up

This week my brother called me to chat.  I can’t even remember when the last time was that he had called me to talk and not to ask me for something. The fact that he just wanted to have a conversation is such a positive sign.  He shared other positive news with me also.  He said that he’s starting to feel “normal” again.  He had a counseling session with his girlfriend (the one he was using with who had overdosed) and came to the realization that it was not good for his recovery to have her in his life.  He has agreed to do counseling sessions with my mom and dad and he has finally given up on his insistence that he would resume suboxone use after rehab.

I met his counselor randomly this week also.  I was at a training on identifying trauma in substance abusers and I overheard a girl say the name of my brother’s counselor.  She was a stocky girl with brown hair, blue eyes, and tattoos covering her arms.  I introduced myself following the training.  She asked, “Have we met before?”  I told her that we had talked on the phone once and that she knew my brother.  My name finally clicked with her.  She immediately started gushing about how well my brother is doing.

My mom talked to my brother’s counselor on the phone this week too.  Just as a bit of backstory, my mom has stayed active in my niece’s life even when my brother was lost in his addiction.  A couple of weeks ago she delivered a letter to my niece from my brother.  He had written that he was sorry that he’s been away so long, but that he’s getting better.  He also asked her if she would forgive him.  My mom said that after my niece read the letter she immediately started writing him a letter back.  The first thing she wrote was, “I forgive you Daddy.”  This letter was delivered to my brother at rehab.  The counselor told my mom that my brother read it silently during a group session and then gave it to the counselor to read out loud to the group.  The counselor said that almost every man in the room started crying.  It was such a powerful moment for them to hear the forgiving words of a six year old.

I am cautiously optimistic.  I haven’t asked my brother yet what he plans to do when he gets out of rehab.  He was living with me before and I don’t know if he will be returning or trying something new.  The thought of him coming back only to disappear into drugs again terrifies me, but I am trying to stay hopeful that this will be a life changing experience for him.  Things are looking up for now.

How the Other Half Lives

How much would you pay for the cure?  Most people would spend a lot to cure themselves or a loved one from addiction.  In fact, last year Forbes reported that the market for addiction treatment in the US is $35 billion per year.

Today I had the experience of touring a rehab facility that is targeted towards those who are willing and able to pay the highest price for addiction treatment.  The facility was small with a capacity of no more than 16 beds, but it sat on 85 sprawling acres of land.  Treatment residents have ropes courses, a beautiful pool area (pictured above), a serenity garden, motor bike rentals, and more.  There are three on-site PhD level staff available 6-7 days a week and a variety of pain management therapies such as massage and acupuncture are available to guests.  The price tag?  $45-60K per month…or half of that if you have viable insurance coverage.

As I toured the facility I noted the wealthy baby-boomer couples touring the space with an obvious eye towards treating their addicted adult children.  The plastic surgery lips and botoxed faces dined on the free hors d’oeuvr as they listened to promises of a cure.  It appears that some addiction facilities do not just sell treatment…sometimes there is false hope for sale too.  To speak of a cure when referring to addiction, which many of us now know tends to require a lifelong recovery process, seemed like a cruel perpetuation of an idea that money can buy you a solution.  There are some things problems that not even wealth can solve.

I wonder how many of these wealthy parents have received real information about recovery and the appalling failure rates of inpatient detox and care facilities, no matter how appealing their environments appear to be on the surface.  How much more could we learn about how to treat addiction through science if these wealthy parents invested in research?  I wish I could have shared those thoughts with those parents…I wish that there was a possibility that they would listen.  Instead of screaming out how I felt about “curing” addiction with opulence, I drank my coffee, took a stroll, and silently inventoried yet another treatment facility lacking innovation and real hope.

 

 

12 Steps: I am powerless over my inability to believe in them.

“I admit that I am powerless over heroin.”

Admitting this is a first step in a twelve step recovery program for heroin users.  It is the step that my brother is struggling with in rehab.

Through his attempts to get clean, my brother has told me that he believes that personal will and commitment is the key predictor of whether someone will stay clean.  In that regard, he doesn’t believe that anyone is powerless to their addiction.  It takes real power to stay off drugs, to change your life, to commit to overcoming your life’s biggest obstacle.

I don’t think he’s wrong.  Admitting powerlessness does not seem like a strength-based approach to recovery at all.  How is that inspiring or motivational?  “I’m powerless, but let me work these steps because somehow that might do something to improve my situation,” I think sarcastically.

I know that there are people that believe in the 12 steps, and there are people that have used that as their tool to live a life in recovery.  Good for them!  It’s certainly not an approach for everyone.

Months ago, in recovery between heavy heroin binges, my brother was attending several Narcotics Anonymous meetings each day in his attempts to stay clean.  I went to a few of them with him, always afraid to let him out of my sight.  They were fascinating.  I sat there listening to people’s stories of hitting rock bottom and finding hope and new lives.  It made me totally relate to the character in Fight Club who became addicted to attending group meetings as a “tourist.”  Now, were the meetings helpful?

Reminders that people get clean and stay clean are great.  Seeing hope in the eyes of those still struggling with addiction in the meetings is powerful.  Following the 12 steps?  Prescriptive.  Dated.  A bad fit for atheists.  Probably not the most effective tool.

I’ve read about some alternatives to 12 step programs that are out there, but the options seem fairly limited.  Many of them are just variations of 12 step programs tailored for atheists or Buddhists.  Very few group programs seem to deviate from the core model.  Let’s face it…the twelve step model was developed nearly a century ago.  The heroin epidemic we face now is unprecedented.  We need more and better tools to help people fight addiction with science-based, person-centered,  and strength-based approaches.  If you know of any supports like that that I can share with my brother, please comment below.  My search continues for new and better ways to think about recovery…

Guilt

My brother is officially in his second week of rehab.  On Monday he was temporarily released for a court date.  After insisting that my brother waive all rights to any day passes at the rehab, the judge officially reinstated deferred adjudication.  Pending a successful three month rehab stint and a year of probation, my brother could still get out of this all without a felony.  One dares to hope.

Now that Joseph’s* rehab is in progress, he is being evaluated and reevaluated and receiving more counseling than ever before in his life.  The doctor’s first order of business was to put my brother on anti-depressants.  He certainly had seemed depressed to me when he was staying at my house.   Joseph’s depression mainly stems from the event that made him want to get clean again.

Earlier this year Joseph contacted me after months of not speaking to me and asked if he and his girlfriend Ashley* could rent a room at my house.  I was weary but I agreed provided that they would be willing to sign a lease.  They first arrived on a Saturday morning around 9 a.m. reeking of booze.  They had clearly been up all night drinking.  They slept most of the day and then left to work their night shifts waiting tables.  They came back home on Sunday around 3 a.m. and went to sleep shortly thereafter.  By 7 p.m. on Monday evening they still had not woken up.  Neither Joseph or Ashley had so much as gotten up to use the restroom, have a glass of water, or eat anything at all.  When they finally got up around 8 p.m. and headed out to their jobs, I did a quick search of their room.  The bloody cotton ball and the belt adjusted to arm’s width were all I needed to see.  I let my brother know that if he wanted to come back to stay then he would have to take a drug test.

He refused and a couple more months went by before I heard from him again.  “Will you please help me buy my prescription?” he asked by text referring to his suboxone.  I agreed to meet him at the pharmacy.  For a hug and chance to see his face, I spent $120 on his medication and another $20 buying him soda and some snacks.  “Ashley is sick so I’m going to share my medicine with her,” he told me.

Yet another couple of months later I was sitting at a bar having a sangria martini with my fiancé when I got the text message.  Joseph said that he was at the hospital and wanted to know if I would buy him some food.  I took him to dinner and he told my fiancé and I over dinner that Ashley had collapsed from pneumonia and was in the ICU.

It was another day before my brother texted me from the hospital and asked if he could come home with me.  “I’m done using,” he said, “and I just need to get out of here.”  Over the course of the next couple of weeks, while my brother suffered through his withdrawals, we occasionally went to the hospital to check on Ashley.  I always went because I could scarcely stand to let my brother out of my sight.

I learned what I think most people don’t realize about heroin. People die from heroin in other ways besides just acute overdose events.  Ashley had a heart infection caused by shooting up, most likely with a dirty and/or used needle.  She had not sought medical treatment when she started feeling ill and her lungs began swelling with liquid.  Joseph had finally taken her to the hospital when she started speaking gibberish and was too weak to walk on her own.  At the ICU, the medical staff put Ashley on a breathing tube and let us know that she may never be able to fully breathe on her own again.  A couple of weeks later, a nurse at the front desk told us that there was no longer anyone by Ashley’s name at the hospital.

My brother blamed himself for what had happened to Ashley.  Ashley had a long history of drug use.  She had even lost custody of her two children in another state.  Joseph claimed that Ashley had moved here to get clean and that he had gotten her using again.

Before Joseph was admitted to the rehab, we learned that Ashley had actually recovered (at least enough to breathe on her own) and was released from the hospital.  Contrary to what the doctors had told me, they did not attempt to detox Ashley and she was discharged with a heavy arsenal of pain killers.  Just like that, she was back in my brother’s life trying to see him.  Thankfully, Joseph got admitted to rehab without any major incidents, but I didn’t sleep for at least a week.

Joseph’s biggest challenge in rehab will be accepting that Ashley made her own decisions to use heroin.  He will also need to think long and hard about his relationship with her, and hopefully acknowledge that having her in his life is probably not the best decision for his recovery.  One of my worst fears is that he will finish rehab, go back to Ashley, and then we’ll never see him alive again.

*Names have been changed.

 

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