I write this for all the courageous, selfless, strong, and determined people who share the common denominator of unconditional love for a person who suffered from and lost the battle to survive a substance use disorder. I write this for those who were blindsided by an assailant that they did not have the super powers to fight, and for those who turned for help to a mental health/substance abuse system that did not have what they needed to save their beloved child, spouse, parent, sibling, relative, or friend.
Each time I hear the word epidemic or pandemic (which is several times an hour these days), I think of the emotional and psychological similarities between our current viral pandemic and what so many people have gone through fighting the opioid epidemic.
When the media shares stories of the heroic, dedicated first responders confronting this deadly virus without enough medical devices or the proper gear needed to save lives, I think about what the family members and other concerned support systems go through living with someone who has a life-threatening addiction, regardless of the drug of choice.
I think about how hard they fought to save the addict’s life. The years of searching for and utilizing the “best” treatment programs, researching the latest miracle medication, attending self-help groups or following self-proclaimed addiction gurus. The years spent finding up-to- date therapeutic interventions, trying a geographical cure, incorporating the “tough love” philosophy of letting them go, or the other extreme of holding them hostage.
And I think about the financial expense. The money spent was not the primary concern. No matter how much, no matter the debt or stress, no matter how many times the addict went into detox, in-patient, sober living, talk therapy, or intensive outpatient, their life was priceless.
There was a dichotomy of emotional response. The mission to save an addict’s life is ingrained in love, but the spectrum of other feelings – anger, hate, fear, guilt, and shame – can be just as powerful and demonstrative, and a motivating push to do more.
And after years of hard work, endless attempts to intervene, sleepless weeks, and financial wreckage, moral and spiritual skepticism replace faith and hope because the worst, most horrific outcome imagined occurs anyway. And the world stops.
The hours, days, months, and years consumed with finding the “cure” to save their life, which was fueled by loving devotion with a mixture of fear and anxiety, is then replaced by an emptiness, a void, a bottomless pit of pain and suffering, and more fear and anxiety.
The fear and guilt are cemented in the thoughts and feelings that they did not do enough to help. The underlining anxiety is the “anticipatory grief” – both physically and emotionally – from the beginning of the journey to save a life.
The energy once spent on finding the right help is now spent on putting one foot in front of another and attempting to get through one more hour, one more day. The loss is indescribable, the feelings of grief are overwhelming, which at times is an understatement.
The preoccupation now becomes a quest to find the answer to: Why? Why did they have to die? Why couldn’t they just get well? Why couldn’t this be fixed? Why did they not listen? Why didn’t anything work?
There are three primary types of trauma: acute, chronic, and complex. Years of living with an active addict is classified as chronic trauma. It is quite common that the traumatic years spent living with active addiction can become traumatic years of living without one.
I have heard it incorrectly stated that being “affected” by someone else’s addiction is a choice. Trauma is never a choice; it is the consequence of a deeply distressing experience. It is the inability to cope with emotional stress that exceeds the normal defense mechanisms utilized for that event.
The effects of trauma don’t always present immediately. A delayed response is common, especially when the situation is a matter of life or death. Family members put their own health, psychological well-being, and even physical needs – food, sleep, and self-care – on hold while they work at what has become a full-time job: trying to protect their loved one from a malady that has stolen their soul and corrupted their mind.
There is very little difference between the emotional upheaval that the current killer virus pandemic triggers and what the loved ones of a person who has suffered, and sadly lost their battle with, the chronic and deadly epidemic of a substance use disorder faced, and in many cases, still grapples with.
Acceptance is a struggle to accept. I don’t mean to sound facetious. What I mean is the emotional fortitude used to fight for a loved one now has to be used to help fight ruminating guilt and a sense of powerlessness.
People don’t have the power to stop the disease, but nonetheless they are powerful moms, dads, wives, husbands, sisters, brothers, and friends. They have the power to forgive themselves. That does not mean letting go of the memory of a loved one. It means letting go of the feelings that bind in a destructive way.
Everyone loved and still loves the one they lost. That love cannot be measured; it is infinite.
But even a small portion of that love can ignite a spark inside. If everyone allowed themselves to love themselves, which might begin with granting themselves permission to accept that they did everything they could, they may very well find forgiveness.
Challenging traumatic thoughts and feelings is a process that needs to occur every day. Finding the inner strength used for years during the addict’s active addiction is in each person’s physical, psychological, and neurobiological makeup. They can confront negative thoughts and feelings.
Utilizing prayer and meditation, exercise, talk therapy, group therapy, self-help and reading is beneficial. So is finding like-minded people who can identify with a shared experience and support each other by listening to each other, sharing experiences, and identifying with the feelings; validating others and allow them to validate you.
People never gave up hope that a loved one would get better, but the fatal illness they suffered from was beyond anyone’s control. There might have been times during the battle when people lost hope because the feelings of fear, anger, anxiety, and depression were dominant. It may have been silent, compartmentalized, or subconscious, but hope was there.
I have learned a great deal about the loving people who stand behind their sons, daughters, siblings, parents, or friends who suffer with addiction. This century’s opioid epidemic has been an intensely painful and unremitting crisis. Even with the knowledge that it was and is a killer, these people did not give up.
Working with families over the years has been rewarding and, at times, emotionally draining. I am deeply grateful that I could be an integral part of their process and witness the evolution of their journey and the way they fought.
Dr. Jean Hager, LCSW, LCADC
April 12, 2020