“Don’t bother coming; he is dead.”
Those words, a week later, still haunt my world. They echo in my head, roaming my mind and refusing to stay still. I am working through the grief.
It is early morning. The day’s usual routine plays itself out. My son is sleepily wandering the kitchen getting ready for school. The smell of coffee is in the air. I had locked and loaded the coffeemaker the night before. I am sleepy, too, and all I can manage first thing in the morning is to push a button. I can hear the sound of cereal hitting a bowl.
“Max, don’t forget to brush your teeth before you leave,” I yell from my room as I dress.
“Mom, why do you tell me that every day?” Max laments.
I reply, as usual, “It is my job as your Mom to help take care of you; that includes your teeth!”
Max and I have had this conversation over a dozen times. Maybe I should stop reminding him, I think, fleetingly. Am I enabling him, not allowing him to take responsibility for his own teeth, or am I loving and protecting him? As I tell my patients, it is a fine line that separates caring for our loved ones from enabling them. But I have no time this morning to really contemplate my parenting style.
I hear the front door. “I love you Max, make it a great day.” I hear a muffled grunt, which I translate as, “Bye, best mom in the whole world, I love you too.” Ok, maybe I am stretching the meaning of my son’s grunt, but it works for me.
I pull my dress over my head. The dress feels too conservative for my style, but I am working today, transporting a young man who has willingly said he will go to rehab.
Two years earlier, I did an intervention with Todd for his family. Todd was addicted to heroin at the time.
He went on from rehab to attend college for two years in a sober dorm, housing designated for kids that have had treatment for addiction. He went on to be a counselor to other, newly sober students.
He returned for a brief time and visited with an old friend—an old friend still using heroin. And with a speed I know all too well from personal experience, Todd used his old enemy, heroin—an enemy disguised as your best friend, a friend that has the ability to manipulate your memory in a way that is incomprehensible, telling you, “We will visit just this one time,” when, in reality, and with rare exception, that “one” visit will end up being a road trip to hell as you once again become addicted.
Todd’s quality sobriety has not been a failure or waste of time, though. He asked for help quickly, within a week of his disease coming out of remission. This is an important point. Addiction/alcoholism is a lifelong chronic illness.
Our success, many times, is when the illness recurs coming out of remission; the addictive stage of addiction becomes much shorter. Addicts who have learned about their disease in treatment and achieved periods of sobriety are armed with facts about the illness coupled with positive experiences of sobriety. These two factors combine and result in the addict seeking help sooner for a relapse.
This is what Todd did—he asked for help quickly—but these days, with strong heroin on the streets, addicts are too frequently passing on before getting the help they need.
That is when I got a text from Todd’s mom, asking for my help in placement and transport to treatment for her youngest son, a son asking for help.
But I was just hours late. The devil beat me to the finish line, and Todd died sometime in the night of a heroin overdose.
Unfortunately, Todd’s death is not unique. Two factors were working against him, increasing his odds of an overdose death.
One, his tolerance for the drug had changed, Having not used heroin for a few years, he needed less of it than he had used previously to obtain the same high. Returning addicts make this mistake all too often, seeking the same old warm euphoria they remember from their previous days of addiction. Simply said, they use a dose of heroin that is too strong for their bodies, which have been abstinent for a period of time. They overshoot the mark and use too much of the opioid; this affects their vital bodily functions, mainly breathing, and they drift off to death.
Two, the heroin of yesteryear is not the heroin of today. The countries that send us illegal heroin are sending America a “weak,” or watered-down, product. Why? Ask them, but I suspect this skimming of the heroin is to save money or make more money. This precious and lucrative commodity comes from countries where a big part of their economy is the illegal export of heroin.
Enter the United States. Drug addicts don’t want to buy a weak product anymore than a person with alcoholism wants to drink .2 beer. So dealers are beefing up the product with fentanyl, a potent synthetic opioid . Fentanyl is also being imported into our country. Where from? Depends on the day. The last big shipment of Fentanyl seized came through Quebec, our northern border. It came into Quebec by ship from a far away port. The point of origin is still debated. The Fentanyl changes hands many times before hitting the US. Currency flows among dealers like the death the drug will bleed down on our citizens. Then there is Carfentanil, a clone of Fentanyl, if you will. I hugely strong form of Fentanyl , originally used to bring down a large animal, like a elephant or lion as a anesthetic.
Amateur chemists add the Fentanyl forms but can’t seem to regulate the strength , and strong batches of heroin laced with it hit the street. Heroin addicts use their usual amount, but that dose has morphed into many times its previous strength, becoming lethal, and the addict dies.
My phone alerts me to a call as I am putting on my shoes to go pick up Todd.
“Don’t bother coming; he is dead.”
I sit on the side of the bed, numb. My first thoughts turn toward Todd’s parents. Their grief is beyond my ability to truly appreciate.
I think of Max, my son, minutes ago slamming the door as he rushed to catch the bus to school.
“God, please watch over my son today, and bring him home to me.”
I will continue my “war on drugs,” as an interventionist, one person, one family at a time. It is my mission as I chase the devil away from the families I am privileged to serve.