This country has no idea how to navigate addiction
I don’t have the answers either. And I’m just a mom trying to help her son.
CW: In-depth discussion of addiction, including overdose; death; grief; suicide, both ideation and attempts. If you’re struggling, there are resources at the bottom.
I’ve written before about my son being sick, but I haven’t gone into much detail because I generally feel like it’s more his story to tell than mine. (While he is technically my stepson, we don’t use step language, at his request.) He has repeatedly given me permission to share these stories, though, and this latest cycle made it very clear to me that it is not only part of my story too, but also just how many other folks are out there living what feels like a double life — their day-to-day life, and their second life, where they are in crisis mode with a loved one who is in active addiction.
My son is 25.
He started receiving mental health care when he was in elementary school. He became actively suicidal at age 14. That’s also the age he entered active addiction after being overprescribed a narcotic at the hospital for the arm he broke while playing basketball. We caught that the prescription was an issue within days, but the addiction had taken root.
This isn’t unfamiliar.
I come from a family of people living with addiction. A family full of chronic illnesses and mental health conditions. There’s a lot of overlap there, in my experience. Not everyone, of course, but I’ve never not been around it. I’m the oldest in my generation, and my cousin — the youngest — died of a fentanyl overdose in January 2021. The only way I can see him now is in old pictures and on a billboard. Several family members have reportedly gotten sober since then. One even opened a transitional living center.
All of which is to say, I’m familiar with how frequent relapses are, I’m familiar with going low contact and no contact, and not enabling, and addiction being a family disease, and all the things… and I’m also still a mom who loves her child, in a system that isn’t designed to support him.
My son has been living on the street for about six months. He was living in my old car until he totaled it in December. Pretty much every day was a barrage of texts and calls about whatever was happening in his world — people wanting to fight him, getting jumped, getting robbed, the car being stolen, and then found again… Sometimes the stories were fantastical, and sometimes they were just downright scary.
Right alongside that were the suicide attempts and overdoses. The phone calls where he would be actively attempting, but wanted to call me to say goodbye and tell me he loves me first. The regular overdoses, and what first responders did or didn’t do (usually, multiple doses of naloxone, removal of his stash, and then leaving him where they found him when he refused the hospital).
His dad, my husband, is also a first responder. He’s responded to some of these calls himself. At least when it’s him responding, he can call me and I can try to get our son help.
Is it a choice?
Our son gets incredibly angry if we call for help. He accuses us of trying to get him locked up, he accuses us of not giving him the choice to die. Is it a choice in that scenario? I don’t know. I don’t know the right thing to do. Am I supposed to sit there and know he’s intentionally overdosing or attempting suicide and not do anything? Some people argue it’s his choice. Is it? If it is, is he in the state of mind to make that choice? I grapple with this shit daily. I don’t know if there is a “right” answer.
That’s one of those question marks in life, one of the answers we’ll never know.
A few days after he wrecked the car, he told me he wanted to get sober. He didn’t know how, and he didn’t know how to deal with the wreckage of his life. He still refused to try rehab again, or meetings again, or any kind of treatment — but he wanted to be sober. We put him up in a hotel to detox, we took him to the ER (twice) to get his withdrawal symptoms under control, and after a week, he asked for treatment. That treatment lasted a week before he relapsed and took off again.
And so the cycle goes. There are tiny windows of opportunity, small moments in time when he is lucid enough to say he wants to be sober, or wants to get better, or wants something different than the life he is living. And we jump into action, because we know any delay at all means the window will close. We get him re-established — clean clothes, medical care, food, a roof over his head, cigarettes and candy to help with the cravings. But the treatments don’t work quickly enough, or the centers don’t have an opening RightNowTodayWhileHeIsReadyAndWilling, or he gets frustrated, or the addiction simply wins out… and he disappears again. Sometimes he makes it a few months, gets a job, finds a place to stay, starts dating, makes some friends. But usually, it’s a week or two.
This last time, he was being seen at one clinic, but the clinic he and I were both most excited about — the one the ER doctor recommended — got back to us the same day he took off, a week after we went in for the assessment. Just a few hours earlier, and maybe the situation would have been different. I don’t know. He had relapsed two days prior, so maybe the window had already closed. That’s one of those question marks in life, one of the answers we’ll never know.
I’m still a mom who loves her child, in a system that isn’t designed to support him.
In January 2020, I wrote the letter below. It’s been sitting in my Notes app since. We’re in a similar part of the addiction cycle again, and, unfortunately, what I wrote then is still true now, because the addiction has become his life — and is worse now, in so many ways — and the system is still broken, and while we as parents are better-informed and better-resourced, we still can’t save our son.
January 23, 2020
I can’t save you, son.
Addiction is a motherfucker.
I haven’t been sleeping well. I worry about you. I worry that I’ve already seen you for the last time. That addiction will take you from me, from us, forever.
Late at night, in the darkness, I look back at your life and wonder how badly I screwed up. Did I miss an important sign? I wonder what stories and hurts you are carrying with you. I wonder what I could have done differently.
This last time, I ignored the signs. You’ve wanted so desperately for us to trust you again, and you needed a win. Good gods, you needed a win. We all did. So I made the decision to trust you when you said you were sober. To overlook the obvious signs of use — the erratic behavior and swinging moods, the spending, the weight loss, the sneaky behaviors, the signs of drug use starting to show on your teeth and skin and in your eyes. The sick. The sudden changes from sick to high. The aggression. The cruelty. The lies. So many lies. Big lies, little lies, everything’s-a-lie lies.
We chose to ignore it for a few days before you walked out the door, crying. High.
I wonder if you’re avoiding us now because of a misunderstanding. Did the boundary we asserted get twisted? Do you even know why you left?
We waited for you to reach out. To at least come get your stuff.
Last week, your dad went in to clean up your room — to pack up your stuff neatly for you, again. He found the pills you had hidden and then left behind, again.
A small part of me wonders if the tears when you left were because you couldn’t find the pills.
It’s been less than a week since I last saw you. Since I tracked you down and offered you a ride. Since you looked at me with dead eyes, and I knew, again, that you’re self-destructing, again, and there’s nothing I can do about it.
It didn’t come out of nowhere.
Before the drug abuse and addiction, we knew something was wrong. We tried to get you help. Sometimes we found it, other times we were turned away for lack of resources, or the wrong insurance, or an “untreatable” diagnosis, or a combination of factors.
The system failed you. For a long time, I believed the system failure was my failure as a mom, our failure as parents. I don’t fully believe that anymore, even as I still wrestle with it emotionally.
It’s been six years.
Six years of trying to save your life. Of showing up, again and again and again. Because we love you. Because you’re our son, yes, but also because we genuinely love you as a person.
Six years of not sleeping through the night. Alert for the footsteps or the knock at the door or the middle-of-the-night call. I’ve missed it twice. I tracked you down the next day, both times, but that’s not the part that you remember. You remember I missed the call.
Six years of therapists and social workers and doctors and all sorts of providers who aren’t trauma-informed, who operate on outdated ideas about addiction, who refuse to see you as a whole person. Who call you a “junkie” and think that’s OK. Who write you off as “oppositional defiant,” or “antisocial,” or “narcissistic,” and call all three untreatable, as if that’s an acceptable response.
A note: These diagnoses are complex, particularly for people in active addiction where the question is often, “Is there an underlying mental health diagnosis, or is the addiction causing mental health symptoms?” And what most people think they know about these diagnoses, including addiction, is probably incorrect. Props to the addiction specialist who taught us this.
Six years of educating myself and advocating for you, and for me, and for our family. Of navigating a failing medical system that isn’t designed to serve people who aren’t rich, and that doesn’t have the resources to help, especially at scale. Like how the state-run rehab doesn’t take state Medicaid. WTF is that?!
Six years of second- (and triple- and quadruple-) guessing everything I know about myself, about you, about life, about trauma, about addiction, about what the “right thing” is in any given situation.
Six years of working through my own self-recrimination and sadness and grief. Preparing myself for the worst, as I’ve been counseled to do, and still hoping for the best. Saving myself so I could show up for you.
It’s been 15 years of “something’s wrong” and “how can we make this better?”
You’re 20 now. We’ve done everything we know to do, over and over again. You know we would go to the ends of the Earth for you.
And I know you don’t have a phone right now. I’m pretty sure you don’t have a place to live either. Maybe you’re crashing with a friend?
You’ve shown up on our doorstep before, and you have our numbers memorized. You know how to bypass my phone’s Do Not Disturb setting, like you did a few weeks ago when you broke up with your girlfriend and just needed someone to listen in the middle of the night.
Do you think we stopped loving you because it happened again? Do you think our grief is greater than our love? We love you endlessly, and I hope one day you will believe that. Maybe one day our love will be the light that you can follow back out of the darkness. Maybe one day you will find your own light.
We can love you while you walk through it, but we can’t save you.
When you’re ready, we’ll be here.
Love,
Mom
Resources
While the system is far from perfect, and there aren’t nearly enough resources available, here are a few you can start with:
The Suicide and Crisis Hotline (you can also text or call 9-8-8)
To Write Love on Her Arms (here is the international database if you live outside the U.S.)
Order Naloxone
https://phra.org/naloxone (free)
https://www.getnaloxonenow.org/#home (donation-based)
I appreciate your words and transparency, and your son’s willingness for you to share his/your story. I started my counseling career in addictions and have worked in basically all levels of treatment from detox on up. Addictions remain so grossly misunderstood and stigmatized, and for this reason are ignored. You’re 1000% right that these systems are not set up to effectively treat and support people through the realities of these conditions. You are so not alone in trying to navigate bureaucratic, logistical mazes within tiny slivers of open windows of opportunity.
I just wanted to reach out and send you both support and strength.