Relapses & Rehab

The news is certainly flying around the internet about the death of Philip Seymour Hoffman. In what I could find about in his biographical information, Mr. Hoffman had a lifelong battle with drugs. He was most recently in rehab in 2006 and in one interview it sounded like he understood his situation as life and death. Thus, staying sober.


Often times, this is what we hear both from our celebrity friends as well as the members of AA, NA and those in recovery. In my own personal experience, I begged and pleaded to get into treatment. Three days into detox, I wished I had never done it even though I was sick and tired of being sick and tired. I did want to get well, but addiction was clouding my judgement. I did believe that I was invincible to some degree. That first round in detox, my liver function tests were relatively normal considering the amount of alcohol I was putting away on a daily basis. I was scared I was doing something bad to my health, but I couldn't see it, so my addict brain convinced me that it wasn't a matter of life and death anymore. The only death I was feeling was the agony of not using for a week. 


Mr. Hoffman died from an apparent overdose of heroin. He was apparently shooting the drug IV and overdosed in the bathroom of his apartment. He died alone in there, doing the only thing his brain felt the need to do. I suspect it was not an intentional overdose. He probably had himself convinced that he would not perish this way. Of course, I don't know any of this for sure. It is just a guess given my own addict mind and now working with so many others who struggle with this disease.


When Whitney Houston died from her drug overdose, I had read a fascinating article on LinkedIn about "Who failed Whitney?" At one point, everybody's hat was in the ring for the blame including Whitney herself. Whitney knew that she was chemically dependent and probably received her fair share of education about the possibility of death if she continued to use - thus, it was her fault. She relapsed as many addicts tend to do and there were people around her who knew it and never got her back to treatment. She wasn't in her right mind- it was their fault for enabling her behavior. Lastly, her treatment team - whatever they worked through in treatment was not enough. She did not have the appropriate tools to stave off a relapse. The treatment center was deficient in their treatment of her addiction. Sadly, I can see valid points in just about everybody's argument. In fact, I see most of these scenarios everyday.


When I look at my own course of addiction, I feel like anything that would happen to me, both good and bad are because of me. When I walked out of the rehab center after my 28 days of treatment, I did not say a word to anyone that I had absolutely no intention of staying sober. I don't think I was quite telling myself that so boldly but everything about my behavior indicated just that. I never went to a meeting. I never told anyone how I was feeling. I attended 2 aftercare groups and then stopped. I had been recommended to participate in the nursing monitoring program but never enrolled because I knew I would be held accountable and I didn't want that. Did the treatment center fail me? I don't think so. They are not there to babysit me and tell me to not drink every time I am on my way to the liquor store. They provided me education and aftercare plans based on what I told them. See, therein lies the difficulty - I had the treatment center convinced that I would be totally fine going home, mainly because I knew I lived alone there and I would have the option to whatever I pleased if I could just get back there. I had them convinced that going to aftercare once a week was going to be plenty because I was SOOOO motivated to be sober. Had I been willing to do whatever it took to be sober, I would have been honest and I would have followed the recommendations of the people who are trained to treat this disease. But I wasn't ready, I just thought I was.


When I went back to using after about 60 days, some of my friends and family knew about it. They were certainly not enabling the use and recommended that I get back doing whatever it was that I needed to do. Beyond that, the responsibility of sobriety is mine. I say regularly to clients, "I can't want your sober life for you." If you don't want to be sober, then you won't be sober. In the AA world, we ask each other, are you willing to go to any length to stay sober? It took me about 6 months after the first treatment, several relapses and a threat of losing one of the most important things to me to be willing to go to any length to stay sober. I used to complain that my monitoring program took away the choice to drink. No, I still had a choice, I could still drink if I wanted to, I was just going to have to play a game of russian roulette to see if I got caught. If I did, I would have to decide that the benefits of drinking outweighed the severity of the consequences if I got caught. 


Back to Mr. Hoffman....it is so sad to see talent like this die from a heroin overdose. From what I hear from people, heroin is back on a resurgence because of the opioid epidemic. Opiates are basically synthetic heroin. The pills on the street are expensive and heroin is not. People end up changing over to heroin in order to sustain the high AND be able to get higher for a much cheaper price. In Minneapolis, I have seen reports that the heroin here is stronger and more potent than anywhere else in the country. People are getting addicted faster and they are dying at a more rapid pace because of it. One former drug dealer told me that when the suburb kids come into downtown to score for the weekend, he will offer one "free" bump on the house in order for 1 more kid to get addicted. He told me the extra bump paid off almost all of the time. Someone who was not even going to buy any, tries and becomes instantaneously addicted. Just more business for him. I don't know if the story is the same in New York, but when people are buying stuff off of the streets, there is truly a threat that the drug could be laced with something, additives are used, etc. Every time there is a risk that this is going to be bad dope, no matter how much you trust your dealer. Or, tonight might be the night, in a stupor, you decide that you need one more bump before going to bed. Without even realizing how high you already are, you inject more, alone and there is no one there to save you. 


What breaks my heart the most about overdose deaths is thinking about how lonely this person must have felt. Sitting alone, in a room, doing the rituals around the use. There is only one focus, one end product, one thing to do to. The action is done, a moment of euphoria and then life turns back to the chase to get the next high. Most addicts will tell you that they are frustrated and annoyed with this lifestyle but don't have the ability to change the pattern of behavior, not to mention access to help is completely limited. If you are out chasing the high, there is not way you are shelling out money for health insurance (which probably won't pay anyway). Most ERs are too over crowded these days and people don't get admitted for help. They will get some drugs to sooth the side effects and get discharged with the recommendations to get help somewhere else. Most of the time, addicts at the final stage of addiction literally have nothing left. No home, no job, no family, no friends. The drug is truly the only friend and probably the worse enemy. My final days of leading up to my last detox, I prayed to God every night to die because that kind of loneliness was just too much to bear. Alcohol no longer was working to fill the emptiness and hopelessness that I felt. I wouldn't wish that pain on my worst enemy. I know that pain and even though the last time I felt it was 4 years ago, I remember very vividly how that felt. I wonder if this is how Mr. Hoffman was feeling in the past few days. 


So, who fails the addict? Who needs to take responsibility for relapse? Who has to bare the brunt of blame for someone dying with 3 young children and a boat load of unused talent? Maybe it is just a little bit of everybody. It's too hard to say. Too many unknown details quite frankly. Heck, the news wasn't even reporting a cause of death until the friend that found him started talking. Immediately, however, when I saw his picture and his age, I knew it was drugs. He looked so aged in his photos. He has the look of a well-fed heroin addict. His eyes look tired. It is sad that we lose so many people this way. I wish I had the answer. 50% of the people who leave treatment have success staying sober. It take an average of 5 treatments for people to stay sober. That's a lot of people who risk life and death everyday from relapse. 


Here is the lesson - get help. Don't die this way. You don't have to.....


Julie

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