My Mom, she tells a lot of lies, she never did before,
Author Unknown
But from now until she dies, she’ll tell a whole lot more.
Ask my Mom how she is and because she can’t explain,
She will tell a little lie because she can’t describe the pain.
Ask my Mom how she is, she’ll say, “I’m alright.”
If that’s the truth then tell me why does she cry each night?
Ask my Mom how she is; she seems to cope so well,
She doesn’t have a choice you see nor the strength to yell.
Ask my Mom how she is, “I’m well, I’m coping,”
She will lie and tell you that she is just fine.
For God sake Mom
Just tell the truth.
Just say your heart is broken.
She will love me all her life. I have loved her all of mine.
I am here in Heaven….. I cannot hug her from here,
If she lies to you don’t listen, please hug her and hold her near.
On the day we meet again, I will smile, I will be bold,
And I will say, “You are lucky to get in here Mom with all the lies you told.”
We were still learning how to live a life without our beloved Josh in it. Grief affected all of us so differently. Logan suffered greatly from losing Josh because, as a teenager, he lost his oldest brother and very best friend. At the time, he was the only child left at home. Combined with a condition of Asperger’s and post- traumatic depression over this loss, he went to a place ridden with quiet despair where we could not comfort him. It was his inability to communicate about the pain he held within that led him to try to manage on his own. He began to self-medicate with prescription pain pills acquired on the streets of our rural community. He told me the year before he died, “you know Mom, there are people your age all around our county who are making a living off of people like me with depression and anxiety.” NO. I did not know that! Medications prescribed for him by healthcare professionals for his depression made him feel unlike himself and jittery. Not much of a drinker of alcohol, he did find some relief by using marijuana, but ultimately found his own way to manage his sadness by using pain pills. Unfortunately, the use of pain medications (opioids) has largely become a drug of choice in our society because, by nature, use of the same, at least in the beginning, goes undetected as it has no smell, is not immediately noticeable when driving or in the workplace. Many can function under the radar and still use. This use, however, sadly led Logan down a destructive path to eventual opioid addiction. Using opioids is like Russian roulette; with all things being equal, not everyone who abuses this class of drug will go down a path of no return. Logan later told me “an old lady in town was selling him Dilaudid to supplement her social security.” And, in the months following residential treatment, he said there were real triggers for him even passing by a pharmacy because that was how he got his drugs; she would send him to various locations to pick up her medications and in exchange for doing that she would share the prescription with him. Ugh. It makes me physically ill to this day that I could not protect him from that. (Note: Today, nearly all states have some form of PDMP, Prescription Drug Monitoring Program. PDMPs collect, monitor, and analyze electronically transmitted prescribing and dispensing data submitted by pharmacies and dispensing practitioners, requiring a check of the data base for patient history and prior schedule 11-V drugs before issuance of other prescriptions.)
Those six years, between Josh’s passing and Logan’s depression were the most challenging of my life. I cannot even to begin to imagine how heart-wrenching that time was for Logan to bear. I know our two other adult children suffered greatly during this time because not only were they frightened about losing Logan, they were afraid to lose us in the process. Seriously, how much more can one family take? We were about to find out. We were all on a roller coaster trying to be supportive and help Logan while we endured the torment of loving someone under the influence of brain altering medications. As his disease of OUD (Opioid Use Disorder) progressed it felt like one punch in the stomach after the other. When your child is no longer a minor a parent has little control or influence over when, where or how to get a child into any kind of treatment. We were terrified of losing another child! Unless you have been in this position, you cannot begin to imagine the fear, heartache and complete desperation and helplessness a parent feels.
Waiting for your child to hit “rock bottom” was never an option for us. That would have been quite unlike our parenting style and would have caused Logan to retreat even more into the darkness of addiction. Every effort was made to follow his lead. During this time in his early adulthood he worked full time in a good job. He went away to college (if only to follow a girl he loved), and he tried to begin to create an adult life for himself.
Living with the disease of addiction often means facing problems alone and in secret. The afflicted become masters of deception about their substance use and misdeeds, both things that cause them overwhelming guilt and shame. Anyone who dares to speak openly about their disease is often met with ridicule, distrust or assumptions of criminal activity. Consideration or compassion for the psychological or mental health factors that may have lead to substance abuse are not likely the first reactions conveyed. The weight of stigma is heavy and shameful which, of course, is the last thing anyone in this condition needs. You cannot make someone feel worse than they already feel because suffering with addiction or alcoholism is ridden with self-loathing and unrelenting regret.
Research tells us that addiction is a disease, and while like other diseases it may be highly influenced by environment, its roots remain of biologic and psychological origin. But rather than treating it like a disease, society treats addiction like a moral failure, a character flaw. Those who suffer – along with those who love them – are isolated by judgment and shame. As a result, the disease often goes unrecognized and untreated with ominous results.
Instead of a network of support, compassion and medical experts on your side, families dealing with addiction face school boards, legal systems and restrictive treatment options and steep financial burdens. Families spend countless hours searching for effective medical care and treatment, at exorbitant costs, in order to help our loved ones suffering with this disease. And even when care can be found, most often the treatment is not rooted in proven scientific and evidence-based treatment modalities, and follow-up care consisted of drug ridden so called SLE’s “sober living environments.”
Unlike other major diseases, there is a relatively narrow window when addiction develops and it nearly always originates from use at a young age. The area of the brain where decision-making, judgment and self-control reside, called the prefrontal lobe, is the last area of the brain to develop, usually in the 20’s. That makes adolescents particularly vulnerable to alcohol and other drugs. Some drugs can arrest the development of the pre-frontal lobe and target the brain’s reward system, literally changing brain circuitry. All of this combines to make it nearly impossible for many adolescents to stop use once they start. Approximately 80% of those serving time for drug related incarceration state they began using alcohol or other drugs before the age of 18.
Despite the staggering facts about the dangers of use, and the present scope of the opioid addiction crisis, the onset of the problem in almost every case is insidious and invisible. The youthful brain is susceptible to addiction with the very first use. This is especially true if they are trying to cope with trauma or social pressures in their circle of friends. Sometimes of course, there is the thrill of risk taking alone that initiates experimentation. No adolescent or young adult believes that he or she could ever become addicted and few parents truly understand how vulnerable and just how quickly children can become dependent. I didn’t.
Once we discovered drug use, every effort was made to communicate our concerns, set boundaries as necessary and a heightened alert to clues for use and abuse. As parents we are focused on our child’s safety, but young people, knowing the risks, are influenced by factors out of our control and as freedom grows so does the opportunity for drug and alcohol use that can go undetected. Teens are very good about hiding their drug use. As parents, we talk about the dangers of drug or alcohol use, but do we ever truly believe that our child will be among the addicted? That is the kind of thing that happens to someone else’s child. Not in our families.
Logan was not a party person. To the contrary, he was uncomfortable in his own skin from the time he was a little boy. In high school after losing his brother when he was 16, he avoided social situations and had a hard time navigating the new normal in his life, which was anything but normal. It was difficult to always be the elephant in the room and as he described to me on several occasions, “I’m just not equipped Mom.” In our small community with our family’s history of involvement on so many levels, there was no getting away from caring people who wanted to give condolences for our loss. It was especially difficult for Logan to interact socially because he was less confident and struggled to communicate his feelings. Immediately following Josh’s death everyone in our circle, family and friends, were on high alert about how Logan would fare. We knew that he was using marijuana, but in view of how the antidepressants affected him, we became permissible to that use. At a school meeting I recall, saying, “yes, he smokes marijuana – but what are we supposed to do because he is heart broken and resistant to sharing his pain – it helps him!” The purpose of this meeting with teachers and administrators was to resolve a plan to get Logan through high school successfully. They all had known and loved Josh, some had had their own battles with children and drug use, and there was not a dry eye among us. Logan could not make sense of the social repartee and wasted time in high school so it was decided that he could finish in the home school program and graduate.
While trying to build an adult life, there were a few times when he ran into scuttles with individuals in and outside the workplace. We suspected that he was in fact drug seeking and that those instances were drug related. What appeared to be a drug experimental phase had led to a downward spiral. His trajectory into becoming physically dependent on opioids was relatively quick and within 1.5 years he descended into serious trouble. The shame he felt during the journey leading to this point, the dishonesty, theft from us, and destructive choices in relationships, not only led to loss of his job and self-respect but also took away the very essence of our beloved child.
By nature, Logan was a homebody. We always welcomed him back home and continued to provide a loving and supporting environment complete with all creature comforts. However, over this time we did drug test. With every positive urine test, we withheld money and the use of his truck. He understood there would be consequences if he continued to use. As his disease progressed from abuse to addiction, his denial of having a problem and rejection of therapy further alienated us all in isolation from him.
Logan adored his father. His shame over past actions exacerbated his guilt and was impossible for him to bear. Without suitable outpatient therapy in our rural area, residential treatment was the only option that would work for Logan and our family. He chose to accept our offers of help and went into residential therapy two times in the year, for a total of 6 months, before he died. I continue to be impressed about all that he learned about himself and shared with me after each time. However, neither treatment protocol offered the dual diagnosis or MAT (medicine assisted treatment) that we were promised existed and we believe both would have been invaluable to his recovery. As a matter of fact, Logan and his brother Josh both came out of treatment feeling even less self-esteem than before they entered.
Despite a supportive family and structured periods of non-use working the 12-steps, they both knew they were not okay. They felt shameful of not feeling okay and dreaded the exorbitant treatment costs born by their family. They felt hopeless and still unprotected from recurring use. I am sure that it was the shame that took my sons long before the last use ever did.
It is unimaginable that anyone would hide from or deny the presence of cancer, diabetes or heart disease, but addiction almost always lives in the dark. It is unacceptable that even in a loving, nurturing and supportive environment, loved ones do not feel comfortable sharing when triggers for recurring use present. How a child can wake Mom from sleep to put a cold rag on his head one week because he has a fever, then not wake me or dad the next week, when triggers present because college classes are a seeming impossible task and succumb to a fentanyl overdose death will always be unacceptable.
That is why I feel an urgent need to open up the dialog, to share stories and make it commonplace to have these discussions. My goal is to make a bold move. To speak out, share information and resources and maybe have that story resonate with another struggling parent. Perhaps we can make a difference in the lives of at least one child, one family, at a time. This disease has the power to control and destroy your family. It has already taken two of my four precious children, literally half of my family gone. Let’s change the minds of society to eliminate the guilt, shame and secrecy surrounding substance use disorder so that our afflicted loved ones will have a greater chance at achieving recovery.
This is what you get when you ask Mom.
~ D