“Addiction is all about more ... always more, and more. And whatever you score, it’s not enough.”
That’s what a heroin addict told me. And that was one of several moments in recent weeks in which I realized how little I knew about addiction and how fleetingly public attention is paid to it.
We are in one of those fleeting moments now.
A few months ago, like a lot of people, I got interested in the growing heroin problem in Ohio. The governor was talking about it. The attorney general was on it — in a big way. The news pages were alerting us. Most significant, perhaps, is what police officers and firefighters told me, off the record: This thing is exploding. People have no idea.
I knew little about heroin addiction, to say nothing of the new heroin fad. I thought of heroin addicts as people sleeping in alleys with very bad teeth. Turns out they drive Volvos and work in banking, the courts, and public schools.
All of us who were ignorant a few weeks ago now know that the new wave of heroin addictions began with pain pills — the scandalous overprescription of pain pills by doctors and dentists. This is being treated as a free-standing scandal, but in truth it is symptomatic of an addictive society — a society in which a great many people are hooked on a great many things — oil, porn, phones, computers, and all manner of consumer goods.
One of the many things we are addicted to in the “just say no” society, is pills. And when painkillers are no longer available, or no longer affordable, people turn to heroin, which is most readily available on the streets of Toledo in two forms — Mexican black tar and brown heroin. Both are cheap — as low as $10 a hit. The price of a flavored martini.
Several addicts have told me, with a shrug, that the heroin craze is simply the latest thing. Some 25 million Americans are drug or alcohol abusers, if not addicts. Another 40 million have a family member or loved one struggling with the booze or drug demons. That’s roughly a fifth of the population. The rate of abuse rises to about 25 percent among the young — ages 19 to 25. About 10 million are said to have co-occurring addictions. To people working in the field, that actually seems like a low number.
We jump from fad to fad in usage and societal response, but I am not sure we learn much. Our knees jerk and our responses are often histrionic but seldom sustained. The problem of addiction in America, and in Toledo, is pervasive and complicated. We don’t like to admit it is either.
As a matter of psychology or public policy, addiction is terribly, terribly complicated. For there is no magic key in either realm. There is no policy panacea. The war on drugs has certainly failed. And in human terms, we are dealing with the mysteries of the heart.
Common sense steps
There is one local policy maker-politician who has a background in drug rehabilitation and actually knows something about addiction — former mayor and current Councilman Jack Ford. He founded SASSY — Substance Abuse Services Inc. He also ran, as part of SASSY, The Road — a residential care facility. With much of the City Council by his side a few days ago, Mr. Ford outlined some common sense steps we can and should take right now to get out in front of the heroin epidemic:
■ Monitor pharmacies so we know who is over prescribing.
■ Crack down on pill sales in public housing. (That may take more police officers and sheriff's deputies, at least on a temporary basis.)
■ Gather more solid data on heroin abuse and fatalities so we know where we are.
■ But the big one is: More residential treatment in Toledo. Defeating heroin takes time. You have to be in a live-in program to kick it.
None of these is a big-budget item. The mayor and the county commissioners could order some of it done now. State help would likely be available.
Even a new residential program could be done relatively inexpensively in co-operation with an existing hospital with empty beds and/or a closed-off ward. ProMedica CEO Randy Oostra might well step up here, if asked.
One addict told me that if she hadn’t gotten a bed in a residential facility the day she decided to quit, she would have died that night.
If we wait until a couple clean-cut kids from Sylvania or Perrysburg die, we will all be full of shame and sorrow. We have to take action, public-policy action as a community now.
Just like us
I wanted to meet some people who had been through this: How do you get addicted? How do you free yourself?
So I spent a little time with five former addicts — one an alcoholic, and four who were addicted to heroin. I will not use any of their real names here, and I am going to try to disguise them a bit, but I want you to know them just a little. They are just like you and me.
■ Mary: Mary is 40ish and struggled with her addiction for years. She is college educated; not only bright, but literate and articulate. Even in casual conversation, she treats words with care and delicacy. She has a son, to whom she is deeply devoted. She has good parents, with whom she is still close. She suffered no trauma in childhood. “I know all the literature says that must have happened to me,” she said, “but I sort of stumbled into heroin.” Her father, like Mary, is in AA and a recovering addict. Mary feels she was saved by a shelter for women where she now volunteers. She is beautiful and compassionate but wary and realistic. She knows how vulnerable she is. She works the program and holds fast to loved ones and service to others.
■ Tina: Tina is ten years younger than Mary. She is also physically striking and formidable. She is less intellectual and more visceral, and maybe tougher because, especially for one so young, she has taken some hard knocks. Her husband, the father of her kids, is in jail. Her oldest son, who is 11, doesn't trust her or his dad. He’s been lied to too often. He's already seen rehab and relapse in both his parents multiple times. She told me that up until about two years ago, when she went clean, not a single relationship in her life was unrelated to drug use. Indeed, every romantic relationship was intertwined with it. She also told me that she knows no one her age who has not used heroin or cocaine. Like Mary, she is white and from the suburbs. Her savior? Her parents. At a certain point, they said “no” to her coming home on her own terms. Did she have a childhood trauma? Yes. She is in therapy for it. Addicts, she said, all have “a hole in their hearts.”
When did Tina decide to kick it? When she woke up in a filling station rest room bleeding from eyes, ears, and mouth. She didn't know how long, she’d been there.
■ Tom: Tom was a successful attorney whose life was destroyed by alcohol. His story is partly textbook and partly a contradiction of the textbook. Booze took his father and his sister. It was in his blood and he is keenly aware that it is still in his blood. But he was successful in work and able in hobbies and had a good marriage and great kids. For him the addiction was not only chemical, but psychic. “I was afraid of a normal life,” he told me. He didn’t want to come out from behind the protective veil of booze and face life in its plainness or its harshness. He feared “every-day-ness” more than arrest, losing his law practice, or death. He has now been sober 20 years and resumed the practice of law.
Tom said he understands two things now: Alcoholism is a disease (as a young prosecutor he thought it was merely criminality or weakness) and “this disease wants me back.” So every day he is vigilant.
■ Harry: Harry was 40 years on heroin. He is one-year clean. He is amazed and thankful that he is here to tell the tale. He credits a judge who practiced tough love. Thanks to that judge, Harry is alive. This judge said: You will do time. You will be incarcerated. But you will be in treatment while incarcerated. And by this combination you will have no choice but to learn about addiction, your addiction, and yourself.
Don’t decriminalize heroin, Harry told me, there will be no leverage on the stubborn addict like himself.
Harry said there was a second tipping point for him: “I was tired,” he says. “Just tired.”
Harry arrived at the shelter where he lives now with a Kroger bag. It contained a toothbrush and three or four articles of clothing. In his 60s, he is learning, in the words of his fellow addict Tom, “the skill of coping with life itself.”
■ Finally, Jane: Jane said she got into heroin for three reasons: It was the 1970s; she was a hippie who wanted to break rules and be free; her boyfriend knocked her around.
She wanted to be Janis Joplin. Except that she didn't want to keep letting down those who loved her, especially her daughter. Jane has been clean for 22 years. She believes the only thing that works in kicking heroin is a 12-step-based residential program that is strict. “It’s got to be tough, she says, and kick your ass, to work.”
After Jane beat heroin, many years ago, she worked at The Road. It was then that she started going out to bars and drinking with fellow social workers and drug counselors. Many drank to excess and Jane became an alcoholic. She then had to beat that addiction — climb the mountain a second time. She did it with the help of Alcoholics Anonymous. “I've substituted Amy Grant for Janis,” she told me.
Pain and loneliness
I have little, but some, direct experience with addiction — one person close to me in early life and one close to me in later life. And what I found with those two people is what I found in speaking with these five people: a keen intelligence and what I can only clumsily call heightened perception. Maybe the best word is soulfulness. These are people you like and you like talking to.
Mind you, these are also people who are hell to live with — who, when in the grip, lie and steal and turn on their friends and loved ones.
As Tom told me, “After the first few years of partying it ain’t fun being us.” Yet the fear of normal life and facing one's self without masks or illusions is so strong that known misery is preferable to the unknown. Addicts, Tom said, usually reach a tipping point at which exhaustion and resolve (to deal with the problem of living daily) converge.
Addiction, said Mary, "is the disease of the lonely." Evey addict feels a profound aloneness in life. This has nothing to do with his number of friends, family, or social engagements. He feels in his heart of hearts, in the words of Hank Williams, “alone and forsaken.”
Second, Tom told me, the addict is an angry person. He feels a profound revulsion at what he feels is the stupidity, intransigence, and weakness of other people. If only he could change them.
Finally, Tina said, the addict cannot deal with truth, especially about himself. That’s part of his need for control: Ultimately, the thing to control is the narrative. “You need someone to call you on your s--t,” Tina said.
Looking for insight into the lure of addiction, and the ability of the disease to reclaim those who once beat it, like Philip Seymour Hoffman, I asked the Rev. James Bacik, a man who is not only a theologian but a longtime parish priest. He told me he was not sure he could help me. But it turned out that he had long experience with addiction, especially alcohol. This included one young man who told him, “If I do this [binge] one more time, I will die.” He did and he did.
“My feeling,” Father Bacik said, “no empirical data here, but my feeling is that the vulnerability [of the addict] is rooted in a hypersensitivity to life.” It's not just that a substance can eliminate that pain for a time, he said, but that the physical distress that follows substance abuse is preferable to the mental anguish of life without the veil: Facing what Tina calls the big hole, what Mary calls loneliness, without help.
Church of AA
All of these addicts wound up in one or more versions of AA (NA, Narcotic's Anonymous is one variation and several had parents or significant others who went to Al-Anon, the support group for families of addicts.)
All five said there were various tipping points and angels in their lives but that the 12 steps are the only thing that has sustained them since.
Well, AA confronts and attacks the loneliness, the desire to control, and the dishonesty and self-delusion. It transfers control to a higher power of your own understanding. And it plugs the addict into a community that will not let the addict hide or make excuses, least of all the excuse that he is alone. With fellow addicts at his back, he is, finally, not alone. They are there for him, they are pulling for him, and they know exactly how he feels when he faces that hole.
AA, says a clergy friend of mine, is “the best church in America.” The one where everyone must be honest and must walk the walk.
There are 400 AA meetings in greater Toledo every week.
We must take the steps in the public policy realm that Councilman Ford recommends. But meanwhile, above and beyond policy, I personally thank God for AA. It saves lives.
We live in a society of addictions, a society in which psychological wholeness and integration are rare. Unless you are a saint or superhuman, you or someone close to you has been touched by addiction.
Heroin is simply the latest manifestation of something eating at our society — something that indicates a fundamental spiritual disorder.
I have a friend who says “the 12 Steps are for everyone” — that there are very few of us in this society who would not benefit from working the program.
The man’s got a point.
Keith C. Burris is a columnist for The Blade.
Contact him at: email@example.com or 419-724-6266.