Tag: stigma

Florida Versus Evidence: How I Lost My Children Because of Past Drug Use

When my first slew of drug tests returned negative, the opposition began slinging whatever they could think of in my direction, hoping something would stick.

I am living in two worlds. One is a world populated by doctors and advocates, run on the tenets of research and science and reason. It is a world in which addiction is treated with medicine, and where there’s no question that people who use drugs deserve to be safe and free of avoidable infections and diseases. In this world, nobody hesitates to administer naloxone if the occasion calls for it. In this world, people are not afraid to touch the bodies of drug users, and we all understand that if you can self-administer naloxone, you don’t need naloxone. I experience this world through phone lines, e-mails, and social media. I write about this world; this world is my template for how all worlds should be.

Addiction as Moral Failure

Then there is the world where my life takes place. In this world, having an addiction is a moral failure. Drug use is met with punishment. Judges replace doctors and toxicologists, making medical decisions and determining the results of drug tests with reckless abandon. In this world, abstinence is the only route to health. In this world, a hit of pot is just as chaotic as compulsive, daily injections of heroin. In this world, there is no sterile equipment; in this world, everyone is sick. Here, you can be sentenced to death just for being the friend of someone who overdoses. This is the world I touch with my fingers and teeth—the world where I walk, and eat, and breathe. This is the world where I live.

I became involved with the Florida Department of Children and Families in April 2018. I was never charged with a crime or afforded the presumption of innocence, evidentiary standards, or jury decision that would have accompanied a criminal charge. Instead, one judge—virtually accountable to no one and equipped with full immunity—deemed my husband and me guilty of some nebulous pre-crime like the woeful characters in Philip K. Dick’s short-story-turned-film “Minority Report.” Apparently, I am guilty of the possibility of neglecting or otherwise harming my children in the future because I have a diagnosed substance use disorder.

Since that decision, I have been forced to obey the mandates set forth by my county’s child welfare authorities in an attempt to win back custody of my girls. So far, not a single mandate has been evidence-based.

I love writing about harm reduction, evidence-based addiction care, and trauma-informed mental health practices. I enjoy staying informed about best practices in addiction medicine. I am proud that I get to help demystify and destigmatize addiction and mental illness, and I am honored to have the opportunity to speak with the researchers who have dedicated themselves to driving us out of the dark ages of addiction medicine. But now that I am living in those dark ages myself, I can’t shake a sense of bitterness: I write about a better world, but it’s one that I only get to view from afar.

Substance Use Disorder Treatment and Geography

In 2017, I wrote an article for OZY about the general disparities between addiction care in red states and blue states. I was living in Seattle, Washington, at the time but I’d had some experience trying to get help for addiction in Florida—so I knew how backward providers could be. For example, when I gave birth to my daughter in Palm Beach while on prescribed methadone, hospital staff refused to let me breastfeed her. She was treated for Neonatal Abstinence Syndrome (NAS) and pediatric staff claimed that enough methadone would be passed through my breast milk to potentially harm her. In reality, numerous studies have found the exact opposite to be true and breastfeeding is now recognized as one of the most effective balms for NAS, due to the maternal contact and general health benefits of breast milk. The amount of methadone passed through breast milk is too negligible to help or harm.

As I wrote in the OZY article, Democratic-ruled states are more likely to offer Medicaid coverage for methadone and buprenorphine, while Republican states are less likely to even offer the medications themselves, much less cover them. People in red states also face harsher penalties for drug crimes and are less likely to be allowed to continue a methadone or buprenorphine prescription while incarcerated. (Though this is a nationwide issue, blue states are leading the reform.) But writing the story from Seattle meant writing from a place of comfort: I was living among the reformers—walking within the pages of history that will be attributed to the good guys. I was able to take my buprenorphine every day because my state insurance covered it. I was surrounded by intelligent, informed people with whom I could speak honestly about my decision to engage in non-abstinence-based recovery. When I wrote about the issues in the system, I wrote from a place of distance. Of privilege.

I did not appreciate how lucky I was until I dove headlong into the true trenches of the Drug War.

In Recovery and Losing Custody

In Broward County, Florida, my children were removed from me because of unsubstantiated accusations of drug use. When my first slew of drug tests returned negative, the opposition began slinging whatever they could think of in my direction, hoping something would stick. Most of it revolved around the fact that I was poor—but ignorance about mental illness and addiction reared its ugly face yet again. The opposition cited my prior child welfare investigation in Florida—the one that was triggered by my daughter’s NAS. It was a routine investigation that had been deemed unsubstantiated. These types of investigations are typically labeled “harmless.” I had been in compliance with my methadone program, and my daughter’s doctors had no concerns—but five years later, the opposition used that prior methadone prescription as a basis for deeming me an unreliable witness: the dirty, lying junkie.

When I was asked under oath whether I had spoken with one of my husband’s siblings about possibly purchasing marijuana, I admitted that I had. Clinicians in addiction treatment recognize that drug cravings are normal and applaud us when we admit that we think about buying drugs but then decide against it. But the guardian ad litem attorney—the counsel whose job it is to protect my daughters’ interests—argued that by considering using marijuana, I placed my sobriety and therefore my children at risk. It didn’t matter that I canceled the purchase and honestly acknowledged that I’d thought about it. The judge called my process of considering marijuana but then deciding against it “drug-seeking behavior.” She gave custody of my daughters to my husband’s parents.

The terribly irony underscoring the entire proceeding is that if I were still living in a state that embraced the most current research on addiction, I would never even have been in a courtroom. The accusation against me stated that I left my daughters in the care of their grandparents for three days while I used drugs outside of the home. According to the U.S. Department of Health and Human Services, “drug tests do not provide sufficient information for substantiating allegations of child abuse or neglect or for making decisions about the disposition of a case.” Drug use on its own, away from any children, is not child abuse. A parent who leaves their child with a family member to go to a bar for an evening is generally considered to be engaging in responsible substance use.

The federal government recognizes that child abuse cannot reasonably be defined as placing a child with a trusted caregiver, leaving the home for a couple days, and returning sober. It doesn’t much matter what went on during those two days. True or false—the accusation against me never described child abuse. A more enlightened jurisdiction would have recognized that. The separation trauma that my children and I have endured over the past nine months is completely attributable to our location.

I used to write about addiction and drug policy from a place of privilege. Now I am writing from the deep trenches. I feel as though I am performing a kind of literary necromancy whenever I publish—except that instead of communing with the dead or demonic, I am writing from within that unillumined place, hoping that, by disseminating research, facts, and the words of distant experts, I can summon reason back into my life.

View the original article at thefix.com

14 March 2019
Should Your Mental Health Determine How Your Pain Is Treated?

Patients with a mental health condition might have a hard time accessing opioids for pain relief, while patients with unexplained pain are often referred to psychiatric care, which does little to alleviate their symptoms. Finding treatment can be frustrating and humiliating.

Four years ago, Dez Nelson’s pain management clinic demanded that she complete a visit with a psychologist. Nelson was surprised, since she had no history of mental illness, but she didn’t feel that she could push back on the request.

“Of course I said okay — I didn’t want to lose my treatment,” Nelson told The Fix. “I was not happy about it, but I did it.”

Nelson, 38, went to the appointment and had a mixed experience with the psychologist. She hasn’t been back since and the pain clinic hasn’t asked her to visit a psychologist again. Still, Nelson said that the experience highlighted — yet again — the discrimination pain patients face.

“It was a condition of my continued care,” she said. “It seemed like they’re bringing it up in a beneficial light, as part of a multi-pronged approach to pain care. But I don’t think [mental health treatment] should be forced on a patient who doesn’t think they need it.”

Chronic pain and mental illness are among the most stigmatized conditions in modern medicine. The conditions frequently intersect and change the way that patients are cared for and treated. Patients who have a mental illness might have a hard time accessing opioids for pain relief, while patients with unexplained pain are often referred to psychiatric care, which does little to alleviate their physical symptoms. At the same time, research suggests there is a strong connection between mental health and pain: depression can cause painful physical symptoms, while living with chronic pain can cause people to become depressed.

All of this makes treating chronic pain and mental illness complex and frustrating for doctors and patients alike.

A Mental Health Diagnosis Affects the Way Your Doctor Treats You

Elizabeth* is a professor in her mid-thirties who had undiagnosed Lyme disease for eight years. Her Lyme contributed to the development of an autoimmune disease that has led to widespread inflammatory and nerve pain throughout her body. Elizabeth also has bipolar disorder. Despite the fact that she has been stable on medication for a decade, her mental health diagnosis complicates her pain treatment.

“Doctors’ demeanor changes when I tell them my medications. When I say I have bipolar disorder, it’s a whole different ballpark. To them that’s clearly a risk factor and red flag for drug abuse,” Elizabeth said.

Opioids are one of the only treatments Elizabeth has found that works to alleviate her pain. But she also takes benzodiazepines on an as-needed basis to control her anxiety (usually once a week). Even though Elizabeth is well aware of the risk of combining the two medications and knows better than to take the two pills together, doctors refuse to prescribe both. They don’t seem to trust her not to abuse them.

“I could tell them that I wouldn’t take them together. But that’s not a valid choice,” Elizabeth said.

While doctors were extremely cautious about this drug interaction, they didn’t focus on another drug-related risk: medications that are used to treat nerve pain can cause adverse reactions in patients with bipolar disorder. No one warned Elizabeth of this danger, and she ended up being hospitalized for psychosis after a long stretch of stability.

“The doctors didn’t talk about it because it’s just a side effect, not a liability concern,” she said.

On the flip-side, Elizabeth has experienced psychiatric providers who were skeptical of her pain diagnosis.

“They wrote in my chart that I had a delusion that I had Lyme disease,” she said.

The Intersection of Pain and Mental Illness

Treating patients with pain and mental illness is complicated because both conditions rely on patient reports rather than objective tests for a diagnosis and to create or adjust a treatment plan.

“Pain is a subjective symptom of the people feeling it. There is no way to measure it,” said Dr. Medhat Mikhael, a pain management specialist and medical director of the non-operative program at the Spine Health Center at Memorial Care Orange Coast Medical Center in Fountain Valley, California

Pain and mental illness can exacerbate each other. In addition, medications for the conditions can interact in rare and serious ways, like what Elizabeth experienced. Finally — and at the forefront for many pain specialists — is the fact that many people with mental health conditions also develop substance use disorders and treating them with highly-addictive opioids can be dangerous.

“We address these issues with patients head on, explain that staying on these medications is very risky for them,” Mikhael said.

Mikhael said that there’s a reason doctors ask patients so frequently about their mental health and substance abuse history. While some patients find that exhausting and repetitive, Mikhael feels it is his responsibility to be constantly evaluating the risk and benefits of using pain medications for people more susceptible to substance misuse or addiction.

“I have to give them the benefits of the doubt, particularly if the history does not show they’re going doctor shopping. I have to trust them and I have to help them,” he said. “But trust has limits. I can’t say I trust the patient and let go.”

My Body Is in Pain, I Do Not Need Psychiatric Care

As the medical community grapples with how to manage pain in light of the opioid epidemic, there is an increased focus on holistic approaches to pain management. Nelson, however, believes this can be harmful to patients who need the pain-relieving power of opioids.

“They’re trying to turn into bio-psycho-social model, and there are people with real diseases who are dying,” Nelson said. “My pain has nothing to do with my psyche. It has to do with the fact that my body is sick.”

Before she was diagnosed with arthritis, emphysema and hemiplegic migraines, Nelson was often sent to psychiatric care when she arrived at the emergency room in pain. She had one provider tell her that facial paralysis — later found to be a symptom of her migraines — was psychogenic.

“Instead of doing their jobs and investigating the physiological issues, they jumped right to the psychological,” she said, pointing to the long history of doctors believing that women’s pain was not real. Eventually, these experiences began to take a toll on Nelson.

“There was a time when I began to question my own sanity. I thought ‘maybe they’re right, maybe this is just in my head.’”

Untreated Pain Is Like a “Time Bomb.”

Both Nelson and Elizabeth have been able to advocate for themselves. While they’ve still struggled with the medical community, they’re been able to improve their care. Yet many people with chronic pain and mental illness don’t have the ability to advocate for themselves in this way.

“I’ve had a lot of education, so I feel comfortable and confident talking to a doctor,” Elizabeth said. She also has the money to be able to travel to a pain clinic and the support of a spouse and therapist.

“I have a lot of these privileges that a lot of people don’t have,” she said. “I’m grateful for that, but I shouldn’t have to be. It should be ordinary.”

Elizabeth often thinks about patients who have uncontrolled or treatment-resistant mental illness, and how that might affect their access to pain relief.

“Should they just not get pain management because they’re not well with their mental illness? Of course not.”

Having in-depth conversations, sharing information between different specialists, and providing community support could all help improve outcomes for people dealing with chronic pain and mental health conditions, she said.

“People need help, not a punitive approach of taking [pain management] away,” she said. “Energy should be put into safe approach to dealing with pain. You can’t ignore it — it’s like a time bomb.”

View the original article at thefix.com

12 March 2019
How Addiction Stigma Prevents People from Getting Help

The doctor believed that people with addictions are sneaky and dishonest, and maybe this is why. My treatment has repeatedly been delayed or denied because I’ve been honest. Do other people have to lie to get medical care?

My name is Sara and I am 28 years old. I grew up in a two-parent household with a loving family, had excellent grades in high school, and graduated from college. I currently work full time. I love children, nature, animals, family, and my many friends.

Self-Medicating with Opioids

I have also struggled with depression, anxiety, and OCD since I was in my early teens. At age 18, my life was changed forever when I was prescribed an opiate painkiller after the removal of my wisdom teeth. I discovered, with that one prescription, that opioids made me feel normal. And yet, opioids are what put me through a roller coaster of hell for the next eight years. They also introduced me to my good friend “Heroin.”

From early on in my addiction, I wanted help but was too ashamed to ask for it. I also figured I could beat this thing myself, but I couldn’t. I needed help. My parents encouraged me to contact a rehab facility, which I did immediately. The nurse who did the intake was very kind and said I could come the next day to be admitted for detox, but she first needed to get approval from the insurance company.

I, and my family, were so relieved that I would begin a journey of recovery. This is when I experienced the stigma of addiction for the first time. The nurse from the rehab center called me back and said that my insurance company would not approve me to go to detox and rehab because I had not yet been incarcerated.

Several months later, I was finally approved for rehab, but only after I possessed a misdemeanor charge.

“Sneaky Drug Addicts”: Doctors Perpetuate Stigma

After detox, rehab, and a six-month stay at a sober living facility, I came home and began looking for work. I found a job quickly, but I needed paperwork completed for a physical. Although the job did not require a drug test and there was nothing on the form requesting drug testing, my primary care provider refused to give me a physical or sign the form unless I agreed to a drug test. It didn’t matter that I was in recovery and was also attending outpatient rehab which routinely drug-tested me.

Even now, with two years in recovery from addiction, I still experience prejudice and stigma in health care settings. Recently a bout of severe food poisoning and dehydration sent me to the emergency room. There, I was accused of going through withdrawal. I provided the nurse with the list of my medications, which included Vivitrol—an opioid blocker. I was also honest and told her that I used marijuana occasionally to help with anxiety. After I was sent for testing in Radiology, the doctor told my mother that he was quite sure that I was going through withdrawal and that he wanted a urine screen. My mother told him that she was sure I wasn’t going through withdrawal because I had always been upfront and honest with her when I relapsed in the past.

“Well, you know how sneaky drug addicts can be,” the doctor said.

When I returned and the doctor told me his suspicions, I agreed to the urine test but told him that I expected an apology after he got the results and I only tested positive for marijuana. I watched as two nurses outside the room laughed and looked toward my room. I knew they were laughing at me—the drug addict.

Half an hour later, the doctor walked in and said, “Well, I guess you were right, you aren’t going through withdrawal. We only found a small trace of marijuana in your system. But, you understand why I had to test you, don’t you?”

He never did apologize to me.

In Recovery and Denied Therapy

Part of my recovery is getting a monthly injection of Vivitrol which is an opioid blocker that also helps reduce my cravings. The provider that gives me the Vivitrol requires that I also go to a counselor, which I was more than willing to do. But at my intake interview at the local mental health agency, I was honest about my occasional marijuana use for anxiety and as a result I was denied counseling services. I even appealed it to the medical director, but that didn’t help. It didn’t matter to them that the anxiety, depression, and OCD—which is relieved by the marijuana—may have been partly responsible for my addiction to opioids in the first place.

That ER doctor held the belief that people with addictions are sneaky and dishonest, and maybe this is why. My treatment has repeatedly been delayed or denied because I’ve been honest. Do other people have to lie to get medical care? If someone is sent to a counselor for emotional eating, are they refused counseling if they have given up everything but potato chips? And even if the providers believe smoking marijuana is a condition of addiction, wouldn’t that be all the more reason to offer me care and a provider? To this day, I have been unable to find a counselor who will take me.

My wish is that every person who has substance use disorder is treated with respect and compassion. When you are addicted, you already beat yourself up every day. Every time you look in the mirror, you see an addict. We certainly don’t need to be reminded by the people that chose a sacred profession and took an oath to help people that we aren’t worth it. That only puts us deeper in the depths of destruction rather than building us up for a path to recovery.

Healing: Compassionate Health Care Providers

My experience isn’t unusual, but I have also encountered many health care workers who were compassionate. Those were the people who gave me a reason to keep fighting for my life. There was a nurse in the emergency department (the one time I was there to get help for withdrawal after I had relapsed) who gave me a big hug when I was leaving and said, “Don’t give up. Keep trying. You are worth it.” And then I watched as she hugged my mother as she sobbed on her shoulder.

“I know it’s scary, Mom, but she will get through this. The good thing is, she wants to get help,” she said.

Another nurse told me how proud she was at how far I’ve come and not to take other people’s biases to heart. And then there was my Health Home Nurse — she just works her magic and does whatever’s needed to help you stay in recovery. She is nothing short of amazing and I owe my life to her. Those are the people who make me want to continue my recovery and the ones I will be thankful to for the rest of my life.

I am Sara. I am a survivor who is recovering from substance use disorder. I could be your daughter, your niece, your granddaughter, your next door neighbor, or your co-workers daughter. I am worthy of being treated with respect and compassion just as much as every human being struggling with this disease is worth it. With the right kind of support, people can and do recover.

Note: My mother, who has worked in the healthcare industry for over 30 years, has been frustrated witnessing firsthand the stigma I’ve faced when trying to obtain care and services. She’s often had to advocate on my behalf. She currently volunteers with an organization called Truth Pharm, which works with local providers to reduce stigma in healthcare settings. She asked if I would be willing to share my story, and that’s why I wrote this.

View the original article at thefix.com

19 February 2019
Glenn Close Discusses Mental Health Stigma

The “Damages” actress spoke about the stigma surrounding those with mental health issues during a recent lecture.

Golden Globe winner and vocal mental health advocate Glenn Close took another opportunity to speak on the dangers of stigma against mental illness during a recent lecture in central Ohio.

The renowned actress was invited to speak as part of the Jefferson Series, described as “a collection of stimulating forums featuring some of the world’s most compelling and esteemed thinkers” that takes place in New Albany, Ohio each year.

During her lecture, Close talked about mental illness in her family and about her book Resilience: Two Sisters and a Story of Mental Illness. Her sister, Jessie Close, has bipolar disorder and Glenn Close herself has dealt with depression at times throughout her life.

However, due largely to stigma against mental illness and a silence around the issue within their family, Jessie remained undiagnosed until the age of 50.

According to a CBS interview from March 2018, Glenn Close was alarmed to discover how often those with bipolar disorder die by suicide and realized that she could have easily lost her sister.

According to an analysis published in the US National Library of Medicine, researchers have found that anywhere from 25 to 60% of people with bipolar disorder have a history of attempting suicide. In the general adult population in the US, the rate of attempted suicide is 0.5%.

These revelations led the two Close sisters to establish the anti-stigma foundation Bring Change 2 Mind in 2010. Glenn Close has since used her fame to speak out against the stigma surrounding mental illness that kept her family quiet on the issue for so long.

“I come from a family that had no vocabulary for mental illness,” Close wrote in 2016. “Toxic stigma and the social mores of the time made any conversation about possible mental health issues taboo. The lack of conversation was very costly.”

In addition to the sisters’ illnesses, Jessie Close’s son, Calen, has schizophrenia and spent two years in a hospital for those with mental health issues.

In her recent lecture, Close encouraged people to examine their own attitudes around mental illness that might be preventing them from seeking help or offering help to a struggling family member.

“You have to examine yourself to see whether you have any kind of stigma that’s just been inadvertently fed into you and then realize your family member can lead a viable life,” she said. “You can have a life, but you have to get help. And the sooner you get help, the better your life will be.”

View the original article at thefix.com

25 January 2019
How Pregnant Women with Substance Use Disorder Are Criminalized

“The more we double down on the idea that pregnant women who struggle with addiction are terrible people and terrible mothers, the easier it becomes for… everyone else to treat them terribly.”

Pregnant women in at least 45 states have faced criminal charges for abusing drugs while pregnant, stemming from the idea that they are doing harm to their unborn babies, according to a New York Times investigation.

Many addiction and recovery professionals, including Dr. Sarah Wakeman, who directs the substance use program at Massachusetts General, say that criminal charges result from and contribute to the stigma around addiction and the idea that substance use disorder is a moral failing or choice rather than a complex medical issue.

“The more we double down on the idea that pregnant women who struggle with addiction are terrible people and terrible mothers, the easier it becomes for doctors, social workers, judges and everyone else to treat them terribly,” Wakeman told the Times, which reported on the issue as part of a series about the rights of pregnant women. “When we criminalize women, we make them scapegoats for all of these large structural forces and societal failures that create poverty and give rise to addiction in the first place.”

At Massachusetts General, the Hope Clinic provides treatment and parenting support for pregnant women and mothers with substance use disorder. By helping women rather than criminalizing them, both mother and child fair better, Wakeman said.

In Tennessee, a law was passed two years ago that could force pregnant women with substance use disorder into jail, essentially claiming they need protective custody. However, the law backfired, resulting in women giving birth in risky situations or leaving the state, said University of Tennessee College of Law professor Wendy Bach. Now, the law is not being renewed.

“We started out saying we would curb drug use and promote treatment and care. We ended up deterring people from treatment while doing basically nothing to curb use,” she said.

Even when substance use doesn’t result in criminal charges, it can cause children to be taken from their families. Kasey Dischman, of Pennsylvania, got sober when she was pregnant with her first child. She maintained her recovery for years, until her daughter was eight and Dischman reconnected with the girl’s father.

Dischman said, “It was like we didn’t know how to be sober together.”

Dischman relapsed. She became pregnant again and accidentally overdosed, resulting in an emergency cesarean delivery for her second daughter.

She said that in the moment when she injected heroin, the pull of addiction was stronger than her concern for her daughters — something she believes shows the power of the illness.

“It’s almost like I forgot about them. I know that’s awful, and that people think I don’t have a conscience,” she said. “But that’s exactly what addiction is. Once it enters your head to do that shot, you develop this tunnel vision that nothing can break.”

Today, Dischman is sober but still facing a complex legal battle in hopes of regaining custody of her daughters, all while feeling like the system is set up against her.

“They don’t want me to recover from this,” she said. “Because if I do, if I make it through and I do all right, then what does that say about them, and about how they trashed me?”

Barry Lester, who specializes in opioid addiction as a professor of psychiatry and pediatrics at Brown University, said that the treatment of women like Dischman is short-sighted and hurtful.

“We love to hate these women,” he said. “But our hatred is not accomplishing anything.”

View the original article at thefix.com

16 January 2019
New York Times Apologizes For "Demonizing" Moms With Crack Addiction

In their apology, the Times’ editorial board acknowledged the negative impact of their stigmatizing coverage of black mothers with crack addiction during the crack epidemic.

When Suzanne Sellers gave birth to her son in 1995, she tested positive for drugs, having become addicted to the crack cocaine that was an epidemic in poor black communities. Despite getting clean, Sellers was coerced into signing away her parental rights, she said.

“I had been sober for over two years at the time I was coerced to sign away my parental rights, despite numerous accomplishments and evidence of a rehabilitated life,” Sellers wrote in an opinion column for The New York Times. “Being black was used against me. Yet there were other factors that compounded the racism and unjust treatment, including my being a woman who was poor, with an unstable living situation, unmarried and, of course, a drug user.”

Sellers was writing about her experience after being featured in an opinion piece in which the Times’ editorial board detailed the ways that the coverage of mothers addicted to cocaine —particularly crack cocaine — contributed to the erosion of a woman’s right to choose and stigmatized a generation of mostly black babies born to mothers who were using drugs.

“Americans were told on the nightly news that crack exposure in the womb destroyed the unique brain functions that distinguish human beings from animals — an observation that no one had ever connected to the chemically identical powdered form of the drug that affluent whites were shoveling up their noses,” the editorial board wrote.

“News organizations shoulder much of the blame for the moral panic that cast mothers with crack addictions as irretrievably depraved and the worst enemies of their children,” the board wrote. “The New York Times, The Washington Post, Time, Newsweek and others further demonized black women ‘addicts’ by wrongly reporting that they were giving birth to a generation of neurologically damaged children who were less than fully human and who would bankrupt the schools and social service agencies once they came of age.”

Sellers said that the paper’s recognition of the dangers of this type of coverage was appreciated.

“I want to thank The New York Times for its apology for how it demonized mothers like me,” Sellers wrote. “The apology is welcomed, and it gives me hope.”

Sellers called on society to do better today, especially in regards to dealing with mothers and children affected by opioid addiction.

“In 2019, no longer should weak science, poorly informed crusaders and racist attitudes continue to shape public policy,” she wrote.

“American citizens, including drug users, have rights. My rights were violated numerous times during my child welfare case, and my family was wrongfully torn apart. When families are wrongfully torn apart, the results are devastating. When the fundamental relationship of every human being — the relationship of a child with his or her mother — is severed, the effects can be irreversible.”

Today, Sellers has resumed contact with both her children, who are now adults. She leads her own consulting firm and a nonprofit, Families Organizing for Child Welfare Justice, and is a homeowner with three master’s degrees.

“I list my accomplishments not to ‘toot my own horn’ but to show that people can and do recover from drug addiction,” she wrote.

View the original article at thefix.com

10 January 2019
The Empty Chair Campaign Highlights Loss and Sorrow Caused by the Drug War

The families of people incarcerated, distanced, or deceased because of the drug war live year-round with the unique suffering of loving someone whose pain you do not have the power to heal. During the holidays, that loss rises to the surface.

Whether you’re celebrating Christmas, Hanukkah, Kwanzaa, New Year’s Day, or something else this winter, the one element that probably shapes your holiday celebrations most is family. For most of us, that’s joyous, stressful, lovely, and anxiety-inducing all rolled into one. For those of us whose extended family will be present, we might even dread the holidays a little bit, fearing the awkward antics of Uncle Joey or the grotesque way our cousin brags about her perfect life. But for families affected by the war on drugs, winter holiday festivities don’t get to be about celebrating your family or nitpicking your sister’s new boyfriend. Instead, they are shaped by grief and loss.

If you read the news at all, or even just scroll Twitter every once in a while, you probably know that drug overdose deaths have skyrocketed. Approximately 175 people die by drug overdose every day. That’s 72,000 each year, and the majority of those deaths — almost 50,000 — involve some type of opioid. Alcohol deaths, which are counted separately, account for approximately 88,000 deaths each year, according to the Centers for Disease Control. So the impact of death due to substance use is huge, all on its own. But losing a loved one to a drug-related death is not the only way families are affected by drug use and the stigma that surrounds it.

The Impact of the War on Drugs at the Holidays

There are currently 200,000 people locked up in state prisons for drug crimes, and 82,000 convicted of drug crimes in federal detention facilities. These people are fathers and mothers, brothers and sisters, uncles, cousins, sons, daughters, and friends. Their loss is felt year-round by those who love them, but families affected by the drug war have an especially difficult time during the holidays. The pain of the season is why, each year since 2012, Moms United to End the War on Drugs runs their Empty Chair Campaign. It starts around Thanksgiving and extends through the December holidays. While families gather to celebrate love, unity, and forgiveness, the empty chair symbolizes those who cannot be present — either through death, incarceration, or the stigma that latches onto people who use drugs or struggle with addiction.

“Part of the goal of the Empty Chair Campaign is to also destigmatize the loss of a loved one through overdose,” says Diane Goldstein, a retired police officer who now chairs the Law Enforcement Action Partnership, a group of criminal justice officials working toward system reform. Goldstein says she was inspired to work on criminal justice reform after watching her own brother struggle with substance use and mental health issues. Eventually, he died of a poly-substance overdose.

“My mother was horribly embarrassed by my brother’s death and couldn’t talk about it,” Goldstein recalls. “I think you see a lot of families who that occurs with, so we are inclusive, not just of the victims of the drug war — which isn’t really a war on drugs, it’s a war on people — but to family members as well. It’s intended to reduce the stigma of the criminalization of drug use, support drug users, and help change the criminal justice system from criminalization to a public health approach.”

The Empty Chair Honors an Absent Loved One

The Empty Chair Campaign uses the symbol of the empty chair at the family table to stand in for the missing family member and highlight their absence. To participate, you can change your Facebook avatar to the empty chair logo, or you can post a photo of an empty chair at your table with a photo of your loved one and a label explaining why they’re missing: incarceration, accidental overdose, stigma, drug war violence.

Gretchen Bergman, the executive director of Moms United to End the War on Drugs as well as its parent organization A New PATH, spent decades living with the overwhelming fear and anxiety unique to parents of children with drug addictions. That anxiety grew as she watched two sons sink into the world of destructive shame, stigma, and involvement with the criminal justice system which is now inextricably linked with addiction, thanks to the drug war.

“My sons both tended to be leaders,” Bergman recalls, “My younger son was always a risk taker. He was the guy who jumped off the roof and dove into the swimming pool…My older son was very thoughtful, more cerebral.”

Perhaps it was that cerebral nature which helped Bergman’s elder son, Elon, survive the prison system as he cycled through during his active addiction. He spent a combined eight years in prison, and three years on parole — and it all began when he was just 20, with a marijuana charge. Elon first acquired a taste for IV heroin behind bars, says Bergman, an addiction which would rule his 20s.

“Today, because of our change of laws, he wouldn’t even be arrested at all,” Bergman notes of her son’s initial marijuana arrest — touching on a bitter truth that the lack of drug law uniformity has created across the United States. Whether or not a person becomes caught in the destructive and self-perpetuating criminal justice system depends largely on when and where they were arrested. Marijuana arrests are also disproportionately weighted against people of color, with the American Civil Liberties Union reporting that black people have historically been 3.73 times more likely to be arrested for marijuana than their white counterparts despite equal rates of use.

Family Celebrations Marred by Grief

For the Bergman family, the war on drugs became a constant, uninvited guest at their holiday celebrations. Year after year, Gretchen Bergman found herself faced with the decision: should she spend the holidays with her son in prison or with the rest of her family? Even when she decided to attend the big family dinner — knowing she’d spend the night nursing her broken heart as she thought of her son cold and alone in his prison cell — she didn’t always have her youngest son Aaron with her, either. Though Aaron never got caught up in the cycle of release and re-incarceration that seems to follow people with felony convictions, he used IV drugs for decades. The shame that often accompanies this type of drug use, which is so heavily stigmatized that even other drug users feel superior to people who use needles, led Aaron to stay on the streets and miss family functions.

“We really thought we were going to lose him because his health was compromised, and he seemed so lost, and he became a multi-drug user,” Bergman recalls. “But I always believed he was still there.”

Today, both of Bergman’s sons are in recovery. Aaron, the younger son, managers a sober living home owned by his older brother Elon.

Julia Negron, who runs the Suncoast Harm Reduction Project in Florida, grew up around drugs. She ended up in the foster care because of her mother’s drug use, and eventually battled her own heroin addiction. She has never known a life not touched by drug and alcohol misuse. And, not surprisingly, she has lost a number of friends and family members to drug-related complications, including overdose. But the experience that haunts her most was the total helplessness she felt as the mother of a drug-addicted child being forced through the criminal justice system instead of guided toward drug treatment that could have truly helped him.

“It’s just terrible,” she says about the holiday celebrations when her son was absent. “It’s not just that they’re not there, you feel they’re unjustly being held somewhere. You feel like it’s a hostage situation.” She recalls packing her family, including young grandchildren, into the car one Thanksgiving and driving them four hours across the California desert to get to the facility where her son was being held. “By the time we went through security and they had to strip search him and do all their stuff on that end,” she says, “they managed to use the entire time allotted to visiting…We never did see him.”

Parents and families of people incarcerated, distanced, or deceased because of the drug war live year-round with the unique suffering of loving someone whose pain you do not have the power to heal. During the holidays, that loss rises to the surface, almost as tangible as the missing person. The Empty Chair Campaign does not seek to cure this sorrow, which won’t abate until the drug war is finally given the ceasefire we all need. Instead, it hopes to bring it to the surface, in order to raise awareness and honor those very real people who deserve their seat at the family table.

“What kind of kills you is you know the person inside, you know who he is,” says Bergman, describing the experience of having a child who is incarcerated for having a substance use disorder. “Right at the time he needs treatment and healing, which would have involved introspection, he’s behind bars, where in order to survive you have to harden your heart. You watch him disappear into that shell that he needed to in order to survive in that cold, concrete, violent atmosphere. It’s terrible to watch.”

Have you lost someone due to the drug war? Let us know in the comments.

View the original article at thefix.com

21 December 2018
HopCat Renames Crack Fries: "Addiction Is Not Funny"

“We chose the name more than 11 years ago as a reference to the addictive quality of the fries and their cracked pepper seasoning, without consideration for those the drug negatively affected,” said HopCat’s CEO in a blog post.

HopCat, a bar that has locations in nine states, announced this week it will rename a favorite menu item: crack fries.

“We chose the name more than 11 years ago as a reference to the addictive quality of the fries and their cracked pepper seasoning, without consideration for those the drug negatively affected. We were wrong,” company CEO Mark Gray said in a blog post from Monday Dec. 10.

“The crack epidemic and the lasting impact on those it affects is not funny and never was,” Gray wrote. “As we grow as a company we have come to realize that to make light of this drug and of addiction contradicts our values of inclusion and community. We want to thank our guests, employees and community members who have helped us come to this realization and apologize for the pain the name brought to others.”

This isn’t the first time the fries have been in the spotlight. In 2015, Dean Dauphinais, a writer for The Fix, reached out to HopCat on Twitter about the name of the beer-battered fries.

“When we started we honestly didn’t think about offending. We just thought it was a good name…” HopCat said to Dauphinais via Twitter.

“This might be a dumb question, but how ’bout just changing the name? There’s NOTHING funny about crack or #addiction,” Dauphinais replied. However, he was a few years too early.

“Not a dumb question, but we have no plans to change the name,” HopCat tweeted. “We hope we can do some good by helping those in need.”

The chain pointed out that they had donated $1,000 from the sale of the fries to a center in Detroit that provides shelter and treatment for people who are homeless.

The name change has been controversial, with some people saying that it represents political correctness gone too far.

“We’ve heard from a lot of people thanking us, and that’s gratifying,” HopCat spokesman Chris Knape told The Chicago Tribune. “And we’ve heard from a lot of people who are not happy, and they’re entitled to that opinion as well. In some ways, it’s flattering that people care that much about the name of a french fry.”

Knape said that while the joke may never have been funny, it falls particularly flat with the nation during an overdose epidemic.

“Times change, we’ve changed and we decided to make a change,” he said. “It’s not a reflection of us wanting to be politically correct as much as wanting to present an image to the world that’s inclusive and recognizes that what may have been funny 11 years ago never really was.”

A new name has not been announced, but HopCat insists that only the name — not the recipe — is changing.

View the original article at thefix.com

18 December 2018
When Treatment Professionals Relapse: Shattering the Stigma

We are treatment professionals: we are trained to help our clients navigate addiction and mental health crises. We aren’t supposed to relapse and have crises ourselves.

In my last article about helping professionals who struggle with addiction and relapse, I wrote about how 37 to 57% of addiction treatment professionals are in recovery and 14.7% relapse over their career lifespan. After readers inquired about my story, I decided to write a follow-up.

“The Blind Leading the Blind”

It was a sunny July day when I started dual diagnosis inpatient treatment for alcoholism and mental health issues at a psychiatric hospital in Fargo, North Dakota. If there was a What Not to Wear: Rehab Edition, I would’ve been a damn good makeover candidate. I was clad in yellow scrubs and those dreaded teal slipper socks, the glass slippers of the mad. My chin-length blonde hair was matted, my wrists bandaged, my face puffy from drinking and binge eating. Shuffling to the pop machine, I ran into a colleague.

I tried to avoid eye contact, but he saw me. I was mortified, ashamed. I had just resigned from my social work job at a drop-in center for at-risk youth. Later, I kept replaying the incident in my head like a ticker tape and longed for Harry Potter’s invisibility cloak. Unfortunately, I encountered something even more awkward two days later.

The scene of this awkwardness was “nursing group,” which sounded to me like a class for breastfeeding mothers. Instead, we learned about the health consequences of drinking, using, and addiction. During the group, I spotted a former client from the YWCA domestic violence shelter. As soon as the group ended, I rushed off to the bathroom, hoping she wouldn’t see me.

I smelled her before I saw her: a familiar alchemy of Estée Lauder perfume and menthol cigarettes. We met while washing our hands.

“I’m surprised to see you here,” she said, applying a coat of peach lipstick.

I wanted to tell her that I was also surprised I landed here, that at only 24 years old I hadn’t yet worked through my trauma and struggle with mental illness. Instead, I said: “I know, it’s probably weird for you, too. I won’t tell anyone how I know you. I ask that you do the same, please.”

They don’t teach you how to handle this sort of situation in social work school. We are helping professionals: we are trained to help our clients navigate addiction and mental health crises. We aren’t supposed to have crises ourselves.

When I told my last supervisor that I was struggling with alcoholism and needed time off to go to treatment, he said, “I support you, but I really need my social workers stable, or else it’s like the blind leading the blind, right?”

After feeling ashamed for days, I imagined a role reversal to have more compassion for myself. What if I saw my former therapists in rehab? Would I really think they were less qualified to do their jobs because they were getting help? After all, I’d rather run into a therapist in rehab or 12-step meetings than drunk at a bar.

Second Chances

Even though I resigned from my social work position, I didn’t want to completely leave the profession. I was still deeply committed to helping others and working towards a more compassionate, equitable society. I was also idealistic, thinking that I would be an even better social worker once I worked through my demons. I imagined myself returning to the profession with renewed passion and vigor.

As a licensed social worker, it was my ethical duty to report my substance abuse and time in rehab to the Board of Social Work. I admit, I was tempted to hide it; I didn’t want to send my addiction and psychological evaluations to complete strangers on the Board of Social Work. After an anxious month of awaiting their consensus, I eagerly ripped open the letter with the state seal. Since I had completed treatment and had an addiction counselor vouch for my sobriety, I was approved to continue practicing as a social worker, so long as I maintain my sobriety and attend 12-step meetings.

While I was grateful for getting a second chance at the profession, I still felt humiliated that I had to turn in all of my psychological records, not just my successful completion certificate. I also wished for some sort of formal support system for people in my situation. I felt so alone in this battle, although I knew there had to be other professionals who had experienced relapse.

You’re Not Alone

A 2013 New York Times article called “Addiction Treatment with a Dark Side” featured the stories of social worker Melissa Iverson and addiction counselor Travis Norton. Both professionals relapsed while working in the addiction field.

According to the article, “Iverson first requested anonymity, like most other professionals interviewed, some of whom have never acknowledged their problem to their families, primary care physicians or even insurers.” Later Iverson contacted the New York Times to “come out of the closet,” saying, “The stigma needs to be tackled by real people with real names, or else it will haunt us forever.”

Back in 2014, I interviewed Norton, who was open about recovering from heroin addiction and owned his own practice adjacent to a Suboxone clinic in a suburb of Minneapolis-St. Paul.

Norton said, “I was on methadone successfully for many years, then switched to buprenorphine (Suboxone). I’ve been on it for almost three years now. For ten years off and on, I have worked in a variety of settings that incorporate harm-reduction and have used the resources personally as a using addict. Because of relapses while working in the field, I am being monitored by my licensing board and am subject to random drug screens.”

Sadly, three months after I interviewed Norton, he died of a heroin overdose. His mother Michelle Norton gave me permission to share his story because she knows that her son wanted to fight the stigma of addiction. He also deserves to be honored for the all the people he helped and inspired. Norton’s death is part of the national opioid crisis. At least two-thirds of the 72,000 overdose deaths in 2016 and 2017 were linked to opioids.

Hope after Relapse

There is hope for those of us who are helping professionals who also struggle with addiction and recovery. Norton and others who wrote to me shared that social work and counseling licensing boards are typically supportive of those who relapse, so long as they follow through with treatment, counseling, or medication assisted treatment like Suboxone or Naltrexone (a medication used for opioid addiction and alcoholism). An increasing number of treatment centers are offering specialized tracks for medical and helping professionals.

Each one of us can work to support this societal shift from stigma to acceptance of our friends, colleagues, and loved ones who work in the addiction field. If you have relapsed, you are not alone. We are not the blind leading the blind, we are strong people who have a special understanding of our clients because we know what it’s like to go through hell and come out the other side. We’ve had a more valuable education than what can be taught in textbooks. We can help clients precisely because we have done the hard work of tunneling from the trenches of addiction to the light of recovery.

View the original article at thefix.com

18 December 2018
French Montana Says He Could Have Saved Mac Miller From Addiction

“If I was around him a couple more nights, I would have made him stop … but he didn’t have nobody that was doing that.”

Hip hop artist French Montana said that he could have stopped rapper Mac Miller’s overdose death by talking to his friend about the way that his drug use was getting out of control.

Speaking on BET’s Raq Rants, Montana said that Miller “was doing the same thing every other artist was doing out there.”

He suggested that if Miller had someone to give him a reality check — or some tough love — the outcome might have been different.

“If you’ve seen the video that me and him did, I’m like, ‘Yo, bro, you’re overdoing it.’ But that was him way before,” he said. “Sometimes if people don’t have people that keep them grounded, it can go left. I just feel like they let him get away with whatever he chooses to do.”

Montana went so far as to say that he could have stopped Miller from abusing drugs and alcohol.

“I feel like I have people that, if I do something like that, how I was to him like a big brother, like, ‘Bro, you’re bugging out.’ … He ain’t have that around him,” Montana said. “Because if I did it that night, if I was around him a couple more nights, I would have made him stop … but he didn’t have nobody that was doing that.”

While Montana might want to believe that he could have helped his friend, anyone with up close experience with addiction knows that facilitating recovery isn’t as easy as just telling someone to snap out of it.

“Substances are incredibly powerful and rewarding,” Kevin Gilliland, a clinical psychologist and executive director of Innovation360 Dallas, told Yahoo Lifestyle. “It’s not as simple as someone saying, ‘You need to stop.’”

Gilliland said that Montana is hinting at some important ways to help people who are dealing with addiction — including keeping them grounded.

“That is often a hugely important piece of helping someone fight addiction, it doesn’t always work,” Gilliland said. “One of the most powerful things I’ve seen for someone getting help for an addiction is having meaningful, significant relationships.”

Talking to someone about their substance abuse and letting them know that you are concerned is a good idea, he added. However, friends and family members have to realize that this doesn’t always work, and that it could make their loved one angry.

“They will get angry and defensive, but you have to talk to them,” Gilliland said.

View the original article at thefix.com

9 November 2018