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Substance Abuse, Treatment, Relapse... Repeat.

I remember back in November my mother calling me and telling me Joey had something happen. He did a drug and had a bad reaction. My mom and him had talked and he agreed something had to change. He had to go inpatient. This would be the first time he agreed to go for help in that way. Joey had been in outpatient a few times and on Suboxone for years. He was terrified of withdrawing. Literally terrified. He did it a couple of times over the years and although I do not know what it is like, I could only imagine judging by his fear of it. He hated his addiction, but the fear of the withdrawal symptoms always won out.

Somewhere along the way, from when he first started subs which was maybe 6-7 years ago up to November, he started compensating the subs with oxy again. We think and are estimating by looking back at behavior changes and pictures (his smile was always a little different when he was in active addiction) that is was probably around October.

I remember going to the house the next day, after the incident and I sat on his bed with him and was just so mad at him. I remember he had this look on his face.... Just kind of angry, sad, ashamed. Angry with himself I think about the whole thing. About the inability to stop this. About the pain he was causing us and the pain he himself was in. About me even being there and my parents telling me about what happened. I asked him to get help. I told him that the kids needed him around and needed him sober. I asked him to let us help him find something. He looked at me and said "Enough". Straight faced, teeth clenched, pale and in need of a shower. He was so pissed that I was even talking to him about it. I didn't push it anymore, I told him I loved him and I walked out of his room. So stupid. But it's what I did.

I went into the dining room and talked to my mom. She was already on it. She had a list of inpatients all over the country. She had spoken to most of them and tried to get as much information about what they needed and what the program was like. She had found one in California where the guy on the phone (I think the founder of the program) was super helpful. He spent a lot of time talking with her and explaining things. My mom was ready to give up the house, sell it, and move with Joey to California so he could attend this center and she would be near by. I totally supported this and told her do what you have to do. Joey never wanted to be alone and there was no way he would go to an inpatient rehab center in California alone.

He didn't wind up going in November... or December or January and in February he did drugs for the last time. So he never went. Life got busy, holidays came up and there weren’t really anymore incidents that we were made aware of... so we thought maybe he was in the clear again... maybe he was using his subs like prescribed... he wasn’t... his dealer knew this but why would that “person” (I use quotes because I have a really hard time even classifying this “person” as a human being), a few other people knew he wasn’t as well (we’ve found this out since he passed) but we didn’t. My mom didn’t give up on the California thing... she kept pushing him, kept on him, kept asking... we just thought we had more time.

My mom and him went to a bunch of local places and with all their different criteria and lack of space, he never found one. Some of them in order to "qualify" for treatment/entrance, you had have a positive urine test, some you had to have a clean one. Some of them you had to literally enter an emergency withdrawing in order to be assessed and treated for addiction , Some didn't take his insurance, some just didn't have the space. So...he didn't go. He continued to see his doctor and continued on Suboxone, Again, at least that’s what we thought.

This is one of our texts about the incident in November. One of our last conversations about his drug use. I hate that I didn't push him harder, hate that I didn't say fuck work, we are going to go all day until we find you a place. Just mad that I didn't try harder. But I know my mom did. I know that we did not fail Joey. We tried, we tried so hard for so long to help him, especially my mom. If you're looking for someone to blame then I guess... Joey failed Joey. An inept health care system failed Joey. An unfortunate stigma failed Joey. A poor excuse for a human failed Joey, people he thought were “friends“ failed Joey... But his family, we did not fail Joey.

Whether this is the first step, the hundredth try, a resistant thrust or a court mandated one... get help for yourself and continue to push your loved ones to get help. Try hard and never give up... Sometimes walking away and letting them hit rock bottom on their own is needed and the only way something changes, we've heard this happen over and over and sometimes it works for some people. If you feel you have to do this, you are not giving up on them... you are still trying to help them, even when you step back. Everyone and every situation in different... It is such a weird, emotional, hard road trying to navigate the world of helping someone you love find their way to recovery, sometimes they do and they will succeed, sometimes they do not. This doesn't mean you failed. You really tried and hopefully they really tried... it just didn't work. This doesn't automatically go into the failure column... and if we got more then one life we would be able to try again, try a different path and continue to have lessons learned and find out what works and what doesn't for you and them. But we do not... life is fragile and the battle is easily lost and extinguished when drugs are involved, especially in 2019. So sometimes, in navigating the road to recovery, there will come the last relapse and it will be the one that halts the journey and your loved one dead. They will lose their battle and you will be left to now navigate a world of grief and bereavement... If you're new here, I'm sorry and welcome to this fucked up version of life after the loss of someone you love to drugs.

The following was written by a friend of mine, a former co-worker and someone in the field. She works in an outpatient center and she helps people in active addiction and in recovery everyday.

"According to the National Survey on Drug Use and Health (NSDUH) 19.7 million American adults-aged 12 and older-batted a substance use disorder in 2017. Furthermore, 70, 237 drug overdose deaths occurred in the United States in 2017, as cited by the CDC.

These individuals are our family members, our friends, our colleagues, our neighbors, our professionals, our public figures, are us. We recognize but do not always respond. We acknowledge but do not always utilize knowledge. With such sizable figures, it is evident that addiction is not something we can turn a blind eye to, as individuals coping with addiction often feel as such to begin with.

Research indicates the importance of treatment, which can encompass any combination of psychotherapy, medicated-assisted therapy, and community-based support groups. With such combinations, individuals learn and develop insight and tools to address a myriad of areas including but not limited to: how to identify the source(s) of their addiction triggers, co-occurring disorders that are both catalyzing and exacerbating their substance use, the impact of substance use on the brain and body, and the role of developing trust in self and others to form healthier life patterns.

Research by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) has shown an estimated 10 million people in the United States will have a combination of at least one mental health and one substance abuse disorder in any twelve-month period. Again, these statistics should not serve as daunting, but rather motivating.

When research and funding is allotted, effective, evidence-based treatment(s) not only become better known, but more readily available to both clinicians and clients. The National Institute on Drug Abuse (NIDA) indicates that drug treatment programs can reduce substance use by 40-60% when clients are actively engaged in therapy. As we recognize the numbers vary widely depending on many factors including clients’ presenting problems and substance-use history, it still highlights the effective outcome of treatment when individuals are provided with the resources they most benefit from having in their lives.

As a mental health professional who works with individuals with co-occurring disorders, I often encourage clients to view recovery like a pie-each piece playing a vital role in their sobriety, and overall wellness in life, and the more pieces we have in the pie, the stronger their recovery becomes. What keeps individuals sober is what they are able to, and aware to add to their “life pie,” be it psychotherapy, medicated-assisted therapy, Alcoholics Anonymous, connection(s) to community, education on addiction and mental illness diagnosises, meditation, spirituality, self-love, animals, recreational pursuits, etc. It all works, when it’s all working.

Samantha Rubinstein, LCSW"

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