by Amy Phariss
Last year, when I began exploring the role of Editor of OutreachNC Magazine, I asked just about anyone I could find to figure out what people wanted to read and talk about. I was surprised when the issue of the opioid epidemic came up often. In fact, nearly everyone I spoke with touched on the subject and the way it affects each of us, individually and collectively. People literally reached out and put a hand on my arm and said, “Please. Write about this crisis. We have to talk about it.”
I am ashamed to admit that when I thought of drug use and addiction, I thought mostly of young people at parties, raging with little pills of Ecstasy or smoking marijuana around a bonfire at the beach. Coming from Texas, where a girl doesn’t do drugs if she wants to date good ol’ ranch boys, I never smoked pot, and the one time I was offered cocaine the look on my face was answer enough. In fact, I was openly judgmental about drug use, blaming addiction on poor personal choices, lack of self-respect and a complete disregard for the effects of said use on loved ones. I figured if people wanted to stop using drugs, it was a simple decision, much like the decision to start using them in the first place, and I felt galled by the idea that addiction might require social services, patience or second chances (let alone thirds and fourths).
Then, because the world is ironic and people often need to learn lessons the hard way, my brother became addicted to opioids.
I could write for months about that experience, about the emotional roller coaster of loving someone struggling with addiction, about the feelings of helplessness when you can’t save someone you love, and about the ultimate humility I found when I stopped judging my brother and started loving him at his worst instead of praying for him to be his best.
As I began researching this subject, I reached out to people in our community for information, and it was like a domino effect. Each person knew another person who knew another person…and on it went. I interviewed people in recovery from addiction. I spoke with spouses, children, employers and community health workers, all about how this epidemic has seeped into each of our lives in a myriad of ways, from the mother who lost her son to an overdose to the husband who watched his wife change before his eyes to the young man who followed in his parents’ footsteps of addiction and finally found his way out.
We begin with the story of a Pinehurst woman who lost her beloved son, Alex, to an opioid overdose two years ago. Over the course of a hot North Carolina afternoon, Stephanie shared with me not only Alex’s story but also her own story, which has its own nuance and detail. So often we view the opioid crisis through the lens of how it affects the person using drugs, but the family members and loved ones have stories of their own, and addiction affects us all, albeit it in different and unique ways. Stephanie’s story allows us to step for a moment into the shoes of a mother whose son’s life became gripped by addiction and ultimately ended in tragedy. We are incredibly grateful for her bravery in sharing.
This interview has been edited for length.
Amy Phariss: Tell us about your son, Alex.
Stephanie: Alex was my son from my first marriage, and then I had four children with my second husband, so I have a total of six children. Alex was a buffer. He was the oldest boy. My ex, my second husband, wanted Alex to be manly and tough, to play football and do all these things. That wasn’t who he was; however, he would try. He never added up. He never felt he was good enough.
Alex started experimenting at the age of 13. He had a hard time connecting with people. Looking back I see several things. I think he had some depression issues. I think it was part of his personality. It was the situation. He never felt safe with other people, so he pretended and then he started acting out. He felt accepted by those who were using and doing drugs. Going from marijuana to who-knows-what….at the age of 18, I had to kick him out of the house. He’d been stealing…lying…
AP: Was he ever abusive to you?
S: No. Never. He was never disrespectful. He would lie to your face. He’d steal from you, with a smile on his face. When he was kicked out, he moved in with a girl. I’d never met her. I get a phone call one evening, and she is frantic on the phone saying that Alex had just been dropped off, literally pushed out of the car at their apartment. Back then, they were afraid that because they’d been using too, they would get in trouble. That’s still a stigma, even though that’s not true anyone. I get to the hospital and sit there for 45 minutes, not being allowed to see him. Finally, I begged, and I get back there. He’s in restraints, still high as a kite. I touched his forehead, and just said, “Alex.” When he heard my voice, he just went limp. Collapsed. They couldn’t get an IV in. He’d had a massive heart attack. He’d been using opana.
At that point, I said: you have a choice. You can go back out on the streets or I will help you go into rehab. He went to a place in Raleigh. He cried every day. He finally just left. He came home, and I said: you’ve got to go someplace. Through a dear friend, I got him into Samaritan Colony. They couldn’t get him in for a week, so we took him to a safe house.
He wavered the whole time. I know I need to go. I don’t want to go. He was so scared.
In hindsight, looking back, and if I were to tell a parent today, I don’t know that I would have made him go because he wasn’t ready.
He did come out of the clouds for four months, after he left Samaritan Colony. He went through the program. He was just…seeing him that clean…I had not seen him that clean and alive since he was 13. Samaritan’s Colony has several halfway houses. He was assigned to the one in SP/Aberdeen. Again, I would never recommend someone going back to the neighborhood and into the town….it’s just too easy for them to fall back into bad habits. Alex left the halfway house early, to live in my ex-husband’s house. When that didn’t work out, he had nowhere to go.
Amy Phariss: Did you think about taking him in?
S: I couldn’t. I had four small children at home. I knew that he was so fresh out of recovery and it was not a good situation. He needed to go back to the halfway house, but because of the way he left, they wouldn’t take him back.
He started drinking again. It was because he was there [in rehab] for me. It wasn’t his decision.
We’d bought him a car. He was living out of his car for 6 months. To this day, I hate going to Walmart. I would go to Walmart, and his car was off to the side. I knew he was either coming off a high or getting high.
AP: Did you ever go to the car?
S: Oh yeah. When he was passed out, you couldn’t wake him up.
We stayed close though. He would lie and say he wasn’t using. He would get odd jobs. He’d try to find work. One day he called and said he wanted to go back to Samaritan Colony. He did the program again. This time they sent him to a halfway house in Dunn. I thought it was perfect. He was away from our neighborhood. Little did I know it was close to Fayetteville and his drug dealer.
He was there for a few months. He got a job. Things are going well. He meets a girl. She gets pregnant. He leaves the halfway house and they got married, even though I said he needed to stay at the halfway house.
He seemed to do well during his wife’s pregnancy. I wondered if he was using again. But when his daughter was born, she was the light of his life. I had so much hope.
After a while, all that stress (new baby, work, wife), he starts using. He’s lying to his wife, to me, to his father. It caused a lot of hurt feelings between his wife and me. I’d call him out on things. He would stay out. He’d come home high.
In April of 2017 I get a phone call. Alex OD’d. He’s on the way to the hospital. He had another heart attack.
I said: wow, he’s overdosed twice. His wife got quiet.
It was his 5th time.
On June 2nd, at 10:30 in the morning his wife calls crying and says, “Alex is dead.”
He’d been using cocaine, and he had 19% fentanyl in his system.
Amy Phariss: What did you feel when you found out he’d died?
S: So….I’m a survivor. I’ve had a lot of tragedy in my life. Probably more than most. I went into survival mode. My first and number one thought was: I’ve got to get to the kids. Fortunately, I was able to tell each of them by themselves. Then I went home and told the two younger ones.
Two weeks after Alex died, his wife found out she was pregnant again.
Let me tell you, it has been the biggest blessing. His first daughter, Ella Grace, she is a ball of sass. Alex just lit up – when he talked about her, was with her, held her. He loved that child. He would play with her, lay in bed
Maddie is now 1. She is a mini-Alex. She looks like him. She is quiet like he was. She has his piercing blue eyes. The kids are polar opposites but they compliment each other so much.
AP: How is the relationship between you and his wife now?
We have worked through everything. You make a decision. Are you going to let things fester? We have worked it out. We have a good relationship to this day. I get to see the kids often, at least once a week, which is great.
AP: What do you remember most about Alex?
S: He was such a southern gentleman. I always told him he would have done well in Charleston. He had swagger. He could melt people. He just had that charm about him.
AP: Do you think his charm was his downfall?
I think his charm was to hide his insecurities. He didn’t consider himself handsome. I think he did use it to his advantage, especially with me. It helped ease the enabling. However when you stop enabling – because there comes a point as a parent, you have to make a decision – and when he went through SC the first time, one of the other people who went through became a very good sounding board for me. He helped me see things in a way I couldn’t see on my own. I went to AA with him. It opened my eyes.
It made me realize I had been judgmental about people who used. I had been judgmental about people who were quote-un-quote ‘addicts.’ It is a dual disease for many. There is mental illness that goes along with it – anxiety, depression, or whatever you want to call it. There is a lot of trauma.
Your instinct as a parent is to save them, to care for them, to pay for rehab.
Honestly, that may not be the best thing for them.
I was told by someone coming out of rehab, “You have to let him fall.”
I didn’t want to do that. I didn’t want to accept.
I didn’t want to take my hands off and let him hit rock bottom because I didn’t know what rock bottom looked like.
In Alex’s case, his rock bottom was death.
If Alex were still living, and I knew then what I know now, my approach would be different. I would ask him to dial back on using rather than telling him to quit altogether.
I’d talk about clean needles. I’d find Naloxone. I’d start small.
AP: Where is the line between enabling and loving?
S: For Alex, my enabling was part of the biggest issue. I think, as a parent, if you’re allowing your adult child to live in your home, eat your food, they’re not working, that’s enabling.
AP: If you could go back and continue enabling him but keep him alive, would you?
S: My head says no. My heart says yes. Because, as a parent, it wasn’t just me and it wasn’t just Alex. It was… there were 4 other people there who I had to protect. He was stealing. His outbursts were unhealthy. So it wasn’t just okay…we’re going to let Alex stay in the house because we don’t want to see him dead. I had to protect these other children. It’s a fine line. You see a marriage fall apart because a child is using. A dad is saying: you’ve got to let him go. The mom says: I can’t.
Alex knew he had a problem. Alex knew he needed help. There was part of Alex that wanted help. There was part of Alex that wanted to live for his wife and his child.
But there was the seduction of the drug, the seduction of how it made him feel, was more of a pull than the love of his family.
AP: What does the grief feel like?
S: You hear people say it will get better. You hear people say your heart will heal. That is the biggest lie on the planet. It doesn’t get better. My heart will never heal. Will it be different? Yes. But it will never heal.
Do I laugh? Yes. But it’s a different laugh.
Will I have fun? Yes. But it’s different.
Will I have joy? Yes. But it’s a different type of joy. Because there is always emptiness in the laugh, in the joy, in the fun. So when you read the cards, when you hear the quotes, it’s not true. It’s absolutely not true.
AP: What do you think the biggest misconception about drug users is?
S: That if you look down the road, it’s the person sitting in the back alley. It’s not. It’s your neighbor. It’s your doctor. It’s your lawyer.
It could be anybody.
Words Matter: The Language of Addiction
Throughout the discussions and interviews I conducted in researching the opioid crisis, the issue of language came up several times, especially regarding the word ‘addict.’ In fact, during a meeting with community health workers, the conversation took a quiet turn when I used this word, and I was politely educated regarding the current thinking when it comes to addiction and the language we use when we talk about the people living with this disease.
From multiple sources, I’ve been told the word ‘addict’ is reserved for use among people who have first-hand, lived experience with addiction; that is, addicts themselves may use the word addict, but for those of us who have not lived with addiction, the word carries a stigma that brings with it a certain amount of judgment.
Stephanie helped me better understand the issue:
The word addict is part of the stigma. An addict can call himself an addict. When I call you an ‘addict,’ I no longer see the person. Taking addict out of it, now I see you. Now I see you as a person. It’s not just the fact that you’re an addict. What else is going on? When you take the word addict or junkie out of it, you’re a user; now I see you as a human being. What in this scenario or situation…what’s causing this? The reason the person starts drugs may not be the reason they continue using drugs.
Why Alex started using drugs was not the reason he continued using drugs. When people say Alex is an addict, you don’t see him as a human being.
When you say: Alex uses drugs…then you have a question behind it. Why? Why is he doing that?
In a 2017 Memorandum from the Executive Office of the President and the Office of National Drug Control Policy, Director Michael Botticelli encouraged Executive Branches to address the terminology related to substance use, misuse and abuse disorders. According to the Office of National Drug Control Policy, “Substance use disorder (the most severe form of which is referred to as “addiction”) is a chronic brain disorder from which people can and do recover. Nonetheless, sometimes the terminology used in the discussion of substance use can suggest that problematic use of substances and substance use disorders are the result of a personal failing; that people choose the disorder, or they lack willpower or character to control their substance abuse.”
What language, then, should we be using?
Here is a list (by no means definitive or exhaustive) of outdated and updated terminology:
- Addict: Person with a Substance Use Disorder or Person Who Uses Drugs
- Clean: Person Not Currently Using Substances or Negative
- Dirty: Person Currently Using Substances or Positive
- Junkies: Persons with Substance Use Disorder
- Users: Persons with Living/Lived Experience
- Recreational Drug Users: Persons who Occasionally Use Drugs
- Recovering Addict: Person in Recovery (which has a range of definitions but typically refers to someone who is stopping or at least reducing substance use to a safer level and reflects a process of change)
- Replacement Drug: Medication-Assisted Treatment (i.e. methadone, buprenorphine, naltrexone, etc. – which are not replacement drugs or substitutions but actually help to reduce cravings and withdrawal and restore balance to brain circuits to enhance healing and work toward recovery) *even MAT is controversial, however, and some in the field suggest simply using the term ‘treatment’
It is also important to make the distinction between the terms, often used interchangeably, dependence and addiction. A person using opioid medication to treat chronic illness may become dependent on the medication, which means he may experience withdrawal if he stops taking the opioids. Addiction, however, is a medical disorder involving compulsion to use more and more of a drug even in light of harmful life consequences.
According to Addiction-ary, the following words come with a stigma-alert and should, therefore, be either replaced or used with caution: abuser, addict, alcoholic, clean, co-dependency, dirty, dope sick, drug, drug abuse, dry drunk, enabling, lapse, medical assisted treatment, opioid replacement therapy (ORT), physical dependence, prescription drug misuse, relapse, slip, substance abuse, substance misuse.
For a more comprehensive exploration of the language surrounding and related to substance use disorder, addiction and recovery, you can visit The Recovery Research Institute’s glossary of addiction-related terms: Addiction-ary at www.recoveryanswers.org/addiction-ary/
Editor’s note: This list and the information provided is meant to start a discussion regarding the language associated with addiction, substance use disorder and recovery and is not meant to define it. The terminology changes or shifts depending on sources, but the primary goal is to treat everyone affected by this disease with respect and humanity, starting with the words we use as we engage and connect on this important topic.