“Dreamland”: Parenting Lessons From a Drug Epidemic

When we moved to the Shenandoah, I heard neighbors complaining about heroin, how they were disgusted about finding needles around the playground, and watching drug deals take place in parking lots.  I’d heard that heroin was popular again, but I greatly underestimated the extent of the epidemic, especially in Appalachia.  My own kids found a few needles in places that were supposed to preserved for their innocence and for community, and I couldn’t get my head around how this had become such a problem. When I was growing up, I was terrified by heroin.  Mostly it was the needles, ‘Trainspotting’ and that scene in ‘Pulp Fiction’ that made me never want to go near it; even in my teenage arrogance I respected its deadly power.  My stupidity about trying different substances always stopped at heroin because people said it would kill me, and I actually believed them.  I couldn’t understand how the generation following me could not see through its thin veneer of bliss to understand these same things, especially to the point where heroin use has become an epidemic.

The book Dreamland:The True Tale of America’s Opiate Epidemic by Sam Quinones helps people who didn’t personally witness opiate use escalate around our country understand how it happened.  What sets this book apart is that in addition to the facts and stories that fed into the epidemic, he also theorizes about the cultural trends that made us susceptible.  It’s a pretty depressing read for parents, but these theories offer important insight about what we teach our kids. We may not be able to help directly with helping people fight their addiction, but parents are on the frontline of making cultural changes to prevent it. What has happened makes it’s clear that our part is more than just warning about the dangers of drug use. We have great influence in teaching and modeling to our kids what is valuable and what is not, and maybe in this way we can help reverse the trend.

Definite Lessons

Be aware of what’s in a pill bottle.   Do your research on what a doctor prescribes your child,  especially if something is possibly habit forming. Even if big pharma or your doctor tells you an opioid, benzo or amphetamine is not addictive, that it has a special time release formula or some other mechanism to keep people from abusing it, take it with caution and lots of education.  Assume that it is still is addictive, because that’s the nature of these drugs.  

Shame intensifies the problem. In Portsmouth Ohio, the city that Quinones identifies as ‘ground zero’ of the epidemic, parents didn’t speak out about what was happening because they were embarrassed. They were trying to navigate things they knew nothing about: rehabs, prison systems, probation, but silently, without help.  They were too ashamed to ask for it, which was silly, because their friends and neighbors were going through the exact same things, but also silently and no one knew.  It took 10 years before a parent in town was able to speak up about it, and form a support group.  If one good thing comes from the opiate epidemic, it’s that there’s a light shining into the hidden worlds of middle and upper class addiction. Because it’s heroin, you can’t just send a kid to rehab silently and expect when they return, life will go back to normal.  Heroin is not just bad behavior at parties and DUI’s, it’s cops, multiple stints in jail, and ambulances in front of your house. You have to have help to support a person through recovery; knowledge and honesty from a community are essential. And since addicts are overdosing more often than people are dying in car crashes, there is no longer time for any parent to shame or be ashamed.

Possible Influences

Kids had their own rooms. Because of our increased affluence and the real estate boom, many kids had their own rooms, which was less common in previous generations.  Kids said that their room was the perfect sanctuary to get high in, away from the cops, nosy neighbors, tattling siblings and any other person who could tell their parents what they were doing.  

And their own cars.  Having a car gave suburban teens easy access to drugs.  You call a number, like you’re ordering pizza, you drive somewhere and meet another driver, and exchange money for drugs. Quinones mentions that the cars also had the added benefit of becoming a place to live when the parents wised up, and kicked their kids out of the house.  

Sports.  I hate to mess with something that has become sacred to so many people. I’m not denying that athletics can be beneficial for children, but that it can be overdone. Quinones noticed that in the middle and upper class communities he was studying youth athletics had been elevated to the point where the problems began outweighing the benefits.  After interviewing an addict in one upper-middle class town he said,  

“It was a place of gleaming mansions, but he felt no sense that education was of value in providing choices for life, much less a love of learning. These kids’ futures were assured. So sports were what mattered. Dads would brag to friends about their sons’ athletic exploits, then berate their boys for poor play, urging greater sacrifice. From the athletic director down to parents and teachers they heard, ‘you need good grades so you can play…’”(291)

Quinones saw that sports were becoming a gateway to opiate abuse because of the pressure and the injuries.  Because of how important sports had become, kids were playing year round starting in early elementary school, and were then more likely to have chronic injuries by the time they reached high school.  And because of the pressure to succeed, they were encouraged to play through their injuries and ignore their pain. They were often prescribed painkillers just so they could finish a season and Quinones noticed that the local football star was quietly becoming the face of teenage opioid abuse. Medicating injuries has always been done, but with oxycodone being prescribed for chronic pain, many sports teams, (and football especially since the players are prone to injury) were developing their own addictions.

Philosophical Questions

What are the consequences  of isolation?  The book is named for the community pool in Portsmouth, Ohio, where generations of kids would hang out all day every day over the summer, surrounded by their neighbors and elders.  It closed in the early 90’s because people began installing their own pools, tucked away neatly in their backyards. People stopped meeting their neighbors and letting their kids roam the streets until dinnertime.  The lack of neighborhood made it easier to hide a drug addiction, away from the watchful eyes and accountability of the community.  Quinones sees this as a metaphor, because it wasn’t just Dreamland that closed, people everywhere started staying in their homes and becoming more isolated. Closed doors made it easier for people to pretend they were perfect, which fueled secrecy and shame about all of their hidden defects.

What happens when we have too much stuff? Maybe not so coincidentally, the peak business years of pill mills coincided with the boom and bust of the housing market.  Quinones theorized that our increasing consumerism created a culture that was fertile for an opiate epidemic.  Unfortunately, parenting has not been immune to this, and the increase in teenage heroin addiction shows the consequence. In an interview with a man running a rehab clinic, the man explained,

“‘Spoiled rich kid syndrome’ seeped into America’s middle classes. Parents shielded their kids from complications and hardships, and praised them for minor accomplishments-all as they had less time for their kids….’You have a lot of kids who have everything and look good, but they don’t have any self-esteem. And you put an opiate addiction in the middle of that?’” (p.293)

Is it possible that minimalism could be an antidote to rampant drug use?  If we wanted less and were satisfied more would we still crave chemicals to fill the gap? Thanks to ‘Charlie and the Chocolate Factory’ we can see that spoiling children is detrimental to their behavior, but maybe we don’t understand that the gravity of the consequence goes far beyond the warnings given by the Oompa Loompas.

What do we lose when we stop accepting pain as part of life? Our culture has also become less tolerant of pain, not just chronic pain, but any pain.  People started getting oxy prescriptions for things Tylenol would normally take care of.  Quinones said,

“In heroin addicts I had seen the debasement that comes from the loss of free will and enslavement to what amounts to an idea: permanent pleasure, numbness, and the avoidance of pain. But man’s decay has always begun as soon as he has it all, and is free of friction, pain, and the deprivation that temper his behavior.” (p.37)

This idea has also trickled into parenting, because we can’t handle watching our children feel pain, physical or emotional. The man Quinones interviewed from the rehab clinic thought that parents today are making recovery even more difficult than usual.  He believed there was a simultaneous epidemic of parents addicted to rescuing their children, and that their kids maturity was stunted because of it.  He had seen too many parents enable addictions by rushing to their kids aid with money, food and shelter when they should’ve been capable of providing it for themselves. People do this because its been their habit since birth, every time a child cries from a scraped knee or because someone was mean to them, we jump to their aid.  He warned, “I tell parents it’s real important to say no, but say no way back when they’re young.” (p.293)

I think most people have heard this before, but have not thought about it in this context.  Whose pain are we really medicating when we come to our children’s rescue, and could the consequences not only lead to irresponsibility, but also to early death? Is it possible to walk the line of being compassionate toward our children without enabling them, starting when they’re still young?

I wish I could offer you a parenting guide, and not just a book review. My kids are still in elementary school and unaware that heroin is even a thing.  I have no credentials other than being able to keep four boys from destroying a house, but I know there’s no sure way to keep kids from trying drugs.  I also know enough about addiction to know that the blame never lies in one place, or on one parent’s shoulders.  The book also reflects that the epidemic has many influences that are far beyond parental control.  There are many kids who had their own rooms, drove their own cars, played sports year round, had lots of stuff, and grew up to be healthy adults. Just as there are kids who grew up with none of these privileges that are still battling addiction.  The influences above are not ways to place blame on the last generation of parents, only cultural observations that the book brings to light with the hope that history might stop repeating itself.

Although you could never place the blame all on one influence, I do think the epidemic shows that it’s important to have conversations about the long term consequences of parenting trends. What do you think of his warnings? Have you seen these things enable addiction? Will you debate the consequences with your friends? I know it’s not a great conversation starter, but we owe it to the parents who have suffered already- to respect the education they earned, and the pain they have endured.

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To Fight a Scourge

I was only 19 when I became a bike messenger.  I didn’t know anything about what I was doing, or the other people who I worked with, but the lifestyle and the conmunity were fascinating.  Everyone was so radically different from each other, but still they were bonded together through the experience of doing such a weird, hard, adrenaline-inducing job.  There was a haunting among them though, that I was still too innocent to understand.

In defense of my naivete, I had little experience with the power of addiction.  In my suburban middle class life, I know people struggled with it, but never publicly.  Occasionally someone’s parents would freak and they would disappear from school. Rumors would be whispered, but the official story would usually be something about boarding school, or visiting an aunt’s house. But being a messenger exposed me to people who were desperately lost in their addiction, who didn’t have the stigma caused by class, and who were to abused by the world to care about what I thought of them.

Working as a messenger was different than an average working class job. Most companies hire you as an independent contractor, meaning you’re free to accept work or not, and you can call out hungover without getting fired. Because you work on a voluntary basis, the job attracts as many drug addicts and alcoholics as it does thrill seekers and cyclists, although for many I knew, these categories overlapped. Instead of hiding the truth or being embarrassed about their drug and alcohol use, it was a safe place to flaunt it. Everyone was just as drunk as you, so a night of bad behavior would be something to laugh at the next morning and not a mirror to reflect the truth about your habits.

What I realized in time was that wherever addicts gather in community, tragedy follows. There was always somebody or something to worry about- a person in jail, an injury that might not heal, or someone living on the street because their girlfriend dumped them. Messengers die all the time, but not from getting hit by cars, or from drug overdose, as my parents assumed.  Some die from being poor, having treatable conditions that they can’t afford to get proper care for.  But more often they die from the side effects of addiction- usually chronic health conditions like cirrhosis, seizures, and cancer. Sometimes the cause is a tragic, intoxicated accident.  The first funeral I remember was for a boy that lost his life in a drunk bar fight, he hit his head funny as he stumbled around, and died in the hospital a few days later.  Since then, about a dozen people have passed away, at least one for every year I’ve been sober, making my own sobriety feel bittersweet.

Losing friends makes me angry.  While we can always do a better job of educating youth for prevention, many addicts already know that drugs and alcohol are bad. Most sober stories begin with that very sentence, “I knew what I was doing was wrong, but…”  People usually know the consequences of their actions, but they do it anyway. Meanwhile those around them, who have been making an effort to act responsibly, are left bitterly carrying the burden. Addiction is a mental illness, but if you haven’t suffered from it, or watched a loved one try to break free, it’s hard to find compassion. 

0905-2017-08067014994580798Between the lost productivity, the health care costs, and the criminal justice fees, we spend an estimated $520.5 billion dollars because of people’s addictions (That’s just drugs and alcohol.  I won’t even go there about smoking.)  Although, the real pain is more than the money wasted; it’s the destruction of our neighborhoods, the broken families, and the trauma it influcts on our children.

May is Mental Health Awareness Month and that includes addiction.  It’s not a purposeful descent into madness to wreak havoc on the rest of us, even though it can feel that way to outsiders. The National Institute on Drug Abuse (NIDA) explains,

“Many people don’t understand why or how other people become addicted to drugs. They may mistakenly think that those who use drugs lack moral principles or willpower and that they could stop their drug use simply by choosing to. In reality, drug addiction is a complex disease, and quitting usually takes more than good intentions or a strong will. Drugs change the brain in ways that make quitting hard, even for those who want to.”

So even if we’re cutting them off financially or emotionally, they still need encouragement to find real help. Currently, out of the 20 million people suffering from addiction, less than 3 million will actually seek treatment, which is pathetic.

Substance abuse has always been a problem in our country, but lately trends show that it’s getting worse, and the consequences have become deadly. It’s not just my friends that are dying. Overdose deaths have quadrupled since 1999, largely to the opioid epidemic. Overdose is the leading cause of accidental death, surpassing deaths by car accidents, guns and AIDS at its peak. 

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 These statistics are horrifying, but they are only half the story.  Like my friends, people die twice as often from the long term damage of substance abuse. According to the CDC, the rate of alcohol related deaths is about about 88,000 people a year, and this article in the Washington Post cites research showing that this rate is at a 35 year high.

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The other reason it’s important to talk about substance abuse during Mental Health Month is that many people who are addicts have a dual diagnosis of another mental health issue, like depression, PTSD, anxiety, bipolar disorder, or schizophrenia.  When we’re scratching our head in anger, wondering why someone made the choice to abuse a drug, even though they knew better, this is often why.  It’s hard to determine an exact percentage of how many people are self medicating, but according to the National Survey on Drug Use and Health in 2014 (p. 32), at least 8 million people have co-occurring disorders.  In my experience that’s a low estimate, many addicts don’t even fully realize they’re self-medicating until they’re sober, and others are unable to stay sober because they don’t realize they’re only addressing half their problem.  

It’s hard to know where and how a person can fight against it,  because what feels like helping an addict is often enabling them, and what’s actually helping they will insist is ruining their life. These are enormous problems, with roots that spread twice as far as the branches and trying to solve them, for even one person, feels like trying to rid your yard of dandelions. It seems like this evil is winning, that we are not powerful enough to fight against it, but we are not that way.

Pray.  “...We do not wrestle against flesh and blood, but against principalities, against powers, against the rulers of the darkness of this age, against spiritual hosts of wickedness in the heavenly places.”(Ephesians 6:12)  This is addiction.  It’s undiluted evil, and it’s a spiritual battle for an person to break free. I am stunned about how few people are publicly praying on behalf of addicts, especially when you consider that almost everyone knows and loves someone who is struggling. We can pray for addicts seeking treatment, that they will find the support they need to get clean, and we can pray for the families that are broken and suffering in silent isolation. The people surrounding them need our prayers, too. Churches need resources for outreach; therapists and counselors need wisdom to diagnose; people running treatment centers need strength and patience. Also, the police, the first responders, jails, local leaders, and elected officers who are overseeing community efforts to fight addiction are understaffed and underfunded.

Pray for this evil to be crushed, but also pray about how you can fight against it.  As I mentioned in my last post, there are grandparents now raising their grandchildren who need babysitters.  There is a nationwide shortage of foster parents. Rehab centers have waiting lists and need beds, money and volunteers. Mentors are needed to teach people in recovery life skills, like how to budget or write a resume. Support a newly sober person by offering them a job or a second chance at friendship. Reach out to someone whose child or spouse is suffering. Sit with them at the hospital and teach them they have nothing to be ashamed ofa.  Many families have no idea where to look for help or answers, and they may need a shoulder to cry on, or someone to pray with them.  

Educate.  I’m amazed at the people who have been caught off guard by the power of addiction and the drugs on the market today.  Heroin is a problem today is because people had no idea that oxycodone was almost the same thing in a perscription.  And how many people would have avoided their addiction altogether if they had known they were suffering from a mental disorder? The more we know about substance abuse, the stronger our communities will be against its influence.  The more we know about the warning signs of what addiction looks like, the less we will enable people to continue in it.   If we were an educated community, we would offer more support to the parents and relatives who feel isolated. Substance abuse is all over the news if you look for it.  Make an effort to research and read about what’s happening in West Virginia, Kentucky, Ohio, Florida, New Hampshire, and in your own state too. Don’t ignore this problem because you don’t see it happening to you.

Speak.  Lawmakers don’t tend to fund research for addiction recovery because it’s not on the lips or the minds of their constituents, so the cause gets shorted compared to other medical research, even though addiction is a major killer.  There are no big 10K races or silicone bracelets sold to raise money for research on subtance abuse disorder.  But if we speak out, if we make this a major issue, lawmakers will fund more treatment centers. Advancements will be made to understand what addiction does to your brain and how we can counter those effects to help people find effective treatment. Teenagers may be more aware of the risks involved. So share articles you find that are important on social media. Talk to people in your church and community about what can be done for outreach. Speak out and make other people aware of what’s going on around you.

In addition to being a voice for legislation and action, you will also be a voice for people who still need help.  One reason the number of people seeking recovery is so small is because of the stigma surrounding it. Every single sober person can help to end that, by coming forward with their own recovery stories. People who have never struggled can help by listening, and not judging those who have been through it. Sadly, stigma doesn’t end with addicts themselves, for the families that surround them are often ashamed to ask for help too.  In Portsmouth, Ohio (a town plagued by overdose), it took almost eight years of living with epidemic heroin use before the parents were willing to confess what was happening in their homes and form a support group.  Don’t let that be your town.  If you’ve recovered or have supported someone who has, tell your story.  Hiding it compounds the consequences. People who are struggling are listening whether you realize it or not, and they need encouragement, so speak out.

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Faces & Voices of Recovery is an organization dedicated to lobbying on behalf of recovery and ending the stigma, because its not just an issue for vagrants and rock stars. Respected people everywhere- leaders, politicians, businessmen, athletes, etc. are in recovery too.  To share your story on social media use #ourstorieshavepower or #recoverymatters or go to their website http://facesandvoicesofrecovery.org/get-involved/  to learn more about joining their movement.

Substance Abuse is a scourge, not just an epidemic, but as a church we don’t treat it this way. When we first moved out here, we visited different churches for a year before I heard someone praying for recovery, or that had a program that was actively pursuing people who needed support.  Spirituality, finding the higher power, is the second step to any recovery, but only a small minority of Christians were acknowledging this, usually the ones that had experienced the pain of addiction personally. 

People even within our congregations are dying, kids are being raised by grandparents and towns across the country are crumbling under the cost. Spiritually speaking, how can we ignore that? Address it in your churches and with your friends. Pray about it and talk about what’s happening, because evil grows in the presence of our apathy, anger, and resignation. Refuse to believe that the fight against addiction is hopeless, either for yourself, a loved one, or your community.  This is your problem, even if it doesn’t feel like it.  Everyone is involved somehow, because 1 in 10 people have a problem which means no community is unscathed. So pray, educate, speak and step up to fight the scourge.

Supporting Foster Care

Substance abuse is an important issue to me personally, because of my own experiences and those of friends and family, but in my opinion, it should be for everyone.  Because as we’ve seen with heroin and crack, a drug problem has the ability to devastate a community rapidly. Also because 1 in 10 Americans struggle with it, which means it’s probably a personal issue for you too.

May is National Foster Care Month and if you don’t care about the problem of substance abuse for any other reason, care about it because of this.  Because while not all children are placed in foster care cases are due to an addicted parent, it is often the precipitating factor.  The number of children in foster care has been rising over the past 5 years, mainly because of an increase in drug use. (Addiction Epidemic Creates Crisis in Foster Care).

According to a government survey, in 32% of foster cases, drug abuse was the listed reason for removal from the home. Neglect was the number one reason, and caretaker inability to cope and physical abuse were numbers 3 and 4 respectively, (AFCRS report, 2015) but that statistics is misleading because neglect, inability to cope, and physical abuse are often a result of a parent’s addiction. Some statistics estimate closer to 61% for infants (Parental Substance Abuse, p2).

Last winter the Wall Street Journal wrote a horrible but informative article, “The children of the Opioid Crisis.”  We can imagine that people who are high won’t be able to properly care for their children, but knowing there are kids living in houses with buckets of vomit everywhere and feces smeared on the wall is unacceptable. It’s also important to remember that substance abuse is a much bigger problem than the current epidemic.  This 2014 article, “Substance abuse a top reason children are removed from homes” focused on the influence of Meth on the Kansas foster care system.  Before that there were the same horrible stories about crack, and before that it was heroin again.  Through all the epidemics, alcohol has always been the substance most commonly abused, and though it is legal, it is equally capable of destroying a family as any hard drug. The fact is, if more people were sober, there wouldn’t be so many kids in foster care.  We wouldn’t be worried about a shortage of foster parents, or a generation being raised by their grandparents, or the psychological fallout that these children are suffering from due to abuse and neglect.

If you think you’re community is immune to these problems, you’re wrong. Statistically, Virginia is one of the states that has been least affected by the increase in drug abuse, but even in the beauty of the Shenandoah things have become worse.  According to the Northern Shenandoah Valley Substance Abuse Coalition the amount of children in Foster care due to parental substance abuse in the  Winchester area soared from 5 cases in 2012 to 42 in 2015.  (Northern Shenandoah Substance Abuse Statistics). One local foster care agency told me that parents who have been recently trained all have children placed with them already. That it only took a few weeks for her to be desperate for more parents to be trained.

During the month of May, please commit to praying for these children. Focus on the Family has compiled a prayer guide to help people understand the needs and problems of foster care and how to you can pray for them here: Foster Care Prayer Vigil  

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Pray for the children to feel love and to find homes that will accept them unconditionally.  Also for the caregivers who are under stress, and for the birth parents sobriety. But also we can pray for the many people behind the scenes working with and helping these families: those providing respite care, the caseworkers, people recruiting and training foster parents, police officers responding to calls, churches who support these families, counselors, teachers, and the communities leaders and government officials overseeing it all.

But don’t just pray for the people already involved, pray for your part too.  It could be as big as opening your home up to a child, or as thoughtful as helping with the cost of clothing, school supplies, or Christmas presents. Many Grandparents that have kinship care are overwhelmed, now trying to raise their grand kids when they were ready for retirement. Offer them help, bring them dinner or babysit for free. Foster children often struggle in school because of the trauma and instability, so if you can tutor, offer your services. Or if you have weekends free, volunteer with the state to provide respite care. 

Speak up for this issue in your church and with your friends, because together we can do more to support the families that take kids in.  Pray for it as a community, and for how you can support their parents recovery, so that the family can have hope of being reunited. Fight for these children, because these kids need it, and our communities need them.