Some of these young men and women have heartbreaking stories of abuse and neglect, but for the vast majority, this simply isn’t the case. They are suburban teens whose families are intact and whose parents were highly involved in their childhood. Many will tell us that their mom or dad coached their sports teams. They are our sons and daughters. They may very well have spent time at our dinner tables and played video games in our living rooms. So, what would make kids with seemingly bright futures go from experimenting with alcohol and marijuana to injecting heroin?

Eyewitness News – A conversation with 10 recovering heroin addicts

The answers are often startling. One teenage boy told me that he became addicted to opiates after abusing Vicodin that he was initially prescribed after he had knee surgery. When it became too costly to support his habit, he turned to heroin, which sells for an affordable four to five dollars a bag. Another young man told me that when his parents got divorced, he was left home alone a lot. He was angry and bored and drugs were a way to rebel. What started off as “harmless experimentation” evolved into heroin addiction with three overdoses.

While teens’ reasons for trying heroin are diverse, one element of their addiction stories remains consistent: heroin isn’t just a drug for them. It is a culture, a lifestyle, a full time job—from buying it, to ingesting it, to financially supporting the growing quantity. It’s the first thing they think about when they wake up and the last thing they think about before they fall asleep. Any positive social networks disintegrate because their old friends no longer want to associate with them and they now have a whole new network of “friends.”

The reality we need to face when treating these young men and women is that the absence of heroin creates a significant feeling of loss. Many of our adolescents struggle with mental health problems in addition to their substance abuse disorder. Recently, I had a conversation with one of our young residents who relapsed during a visit home. He was progressing extremely well in our program, so I asked him what made him start using again. With tears in his eyes, he told me, “I don’t know what else to do. I don’t know the first thing about making new friends.”

His response highlights a key priority for those of us who treat adolescent heroin users. It’s not enough to assist them with their sobriety. Without healthier activities to replace the rituals and habits that surround their drug use, the chances of long-term recovery are slim. For this reason, we have incorporated healthy forms of recreation into our treatment framework. We anticipated that our boys and girls would enjoy learning martial arts, but we’ve been surprised by the popularity of our yoga and meditation sessions. An inter-program basketball league is also in the works. In addition, we’re educating the residents about healthy nutrition.

Our goal is not simply to facilitate abstinence, but to foster a whole life change. Recovery is not easy. It requires daily commitment to life-changing choices like any other chronic condition such as diabetes, high blood pressure, or heart disease. Treatment must be transformative. We need to give them the tools to reduce and eliminate high-risk behaviors, live healthier lifestyles, mend broken relationships, and build new ones.

We are daily witnesses to the devastations of heroin addiction on our residents and their families. The tragic reality is that relapse is a part of recovery and at times, a very unforgiving part. But there is nothing more rewarding than watching our kids accomplish goals they once thought were unattainable—achieving success in school, developing positive social networks, exploring new hobbies, reclaiming their place in their families, and becoming productive members of their communities. Rather than struggling with the how’s and why’s, we remain certain that recovery is possible, but only if we focus on the whole child, not just the addiction.

Traci Donnelly
Vice President and Regional Director, Phoenix Houses of New York and Phoenix Houses of Long Island

As heroin addiction among our youth continues to rise, residents of Long Island are beginning to see that an “anywhere but here” way of thinking creates a false sense of security. One of the communities to come to this realization is Sayville, once dubbed “the friendliest town in America.” Last Thursday night, a crowd of more than 600 concerned residents gathered in the auditorium of Sayville Middle School to discuss the heroin problem that has claimed too many young people.

Although I wasn’t at the meeting, I recently took part in a similar conversation with journalist Perri Peltz on SIRIUS XM’s Doctor Radio program “Is Your Kid High?” I imagine that the other panelists and I were attempting to answer the same questions as the residents of Sayville: What should parents do if they suspect their teen may be heading down the wrong path? How do they protect their children? What about respecting their privacy? Do kids have rights?

What I tried to emphasize on the program—and what I would have said had I attended the Sayville event—is that the warm, fuzzy feeling between parents and their children can be a bi-product of parenting, but is not the purpose. A parent’s job is not to be their children’s friend, but to prepare them for a healthy, successful adulthood where they can make the best choices. Therefore, if you notice signs that your child may be experimenting with drugs or drinking, do anything you can to protect your child, including “snooping.” I know of parents who eventually took off their teenager’s bedroom door after discovering a drug problem. While this may seem extreme, I don’t think it’s going too far if the circumstances require it. 

Likewise, if you have reason to believe your kids are using, buying a drug testing kit at the drugstore is another tool to help keep them safe. Testing also has the added benefit of giving your children an easy out next time they’re offered drugs or alcohol; they can simply say, “I can’t. My parents test me.” But, don’t test until you know what you’ll do with the results—positive or negative.

Finally, remember that there are no guarantees. Sometimes all the snooping and tough love in the world won’t stop substance abuse. Ask my parents! Addiction is a chronic medical illness, just like hypertension, diabetes and asthma; all have genetic, environmental, and behavioral components. 

But for every life lost—for every John Belushi, River Phoenix, and DJ AM—there are people like myself and two inspiring young men, Adam Parbus and Naveed Etemadipour.

Adam, the 20-year-old guest speaker at Sayville Middle School who started using drugs to ”be cool,” survived an overdose from a lethal mix of heroin, Xanax, and vodka. He received treatment at our East Hampton Academy and recently said he’s grateful to be alive and drug-free for over a year. 

Naveed, my fellow panelist on the Doctor Radio program, is now a part-time counselor in training at Phoenix House after a stay at our San Diego Academy. Offering his thoughts on parenting, he said, “Being cuddly and friendly [is what parents think they should be]…but being strict is being a parent. You can’t force your children to make the right decisions, but you can guide them. That’s what I lacked—the structure and tough love—and that’s what’s most important.”

As a person in long-term recovery, I salute Naveed and Adam’s courage to share their stories and I urge parents on Long Island and other communities across the country to know the warning signs and take action—before it’s too late.

No doubt, committing more troops to the war will mean more soldiers exposed to combat, more individuals left with life-changing injuries, and, as a result, more men and women turning to drugs and alcohol to numb their physical and psychological pain.

Having worked as a psychology intern at the Brooklyn VA, I have witnessed the complicated mental health issues many military personnel confront. When they return from war, their brains do not automatically flip a switch that allows them to readjust to civilian life. Consequently, the mental shift that occurs in the war zone can lead to a host of lingering symptoms, not limited to insomnia, flashbacks, nightmares, and paranoia. Searching for relief, they are prone to self-medication through illicit substances. Others become addicted to the heavy painkillers prescribed to treat their physical wounds.

Often exposed to intense combat trauma—beyond the normal realm of exposure—those who have served in Afghanistan and Iraq are particularly vulnerable. Many face multiple deployments, which increases the likelihood of injury and intensifies the “battlemind” they develop to survive. To date, an estimated 300,000 Iraq and Afghanistan War vets have post-traumatic stress disorder.

These profound challenges make Afghanistan, Iraq, and other military personnel a special population when it comes to treating addiction. Above all, when they seek help, they’re looking for people with military credibility who speak their language. For this reason, we as treatment providers have a responsibility to recruit and train staff who are educated to understand their experience.

In addition to dealing with vets’ chronic pain and psychological wounds, we must be prepared to address other critical issues that can trigger substance abuse, including homelessness, unemployment, and family difficulties.  The VA estimates that about 131,000 vets are homeless on any given night and approximately twice that many may experience homelessness over the course of the year. About one out of every three homeless adults have put on a uniform and served our country. More than 70% of homeless veterans suffer from alcohol and other drug abuse problems.

When it comes to employment, in a 2007 Military.com survey, three-quarters of vets entering the civilian workforce reported “an inability to effectively translate their military skills to civilian terms.” The same survey found that 61% of employers felt they lacked “a complete understanding of the qualifications” of former service members. To this end, helping those who have served gain employable skills should be a component of an effective recovery plan. Of equal importance, we must extend counseling and support to family members, who are directly affected by the trauma servicemen and women experience, but who currently have limited resources for help.

This holistic strategy is part of our coordinated effort as we lay the framework of our new Veterans Program. While the VA and DoD have identified military-related mental health-issues as a top concern, they have also emphasized the role of local agencies and nonprofit organizations to help expand the available care and reach more service members, vets, and their families. With this in mind, in the coming months, we will meet with military personnel who are currently in treatment and begin to develop a program specifically tailored to meet their needs.

Although we cannot predict the fate of the men and women who will join our forces in Afghanistan, it is our duty to ensure that when they return, we will be there.

On Thanksgiving, as I sat at the table, stuffing myself with turkey and pumpkin pie, I thought what a miracle it was that I was there at all. I surveyed the room filled with loved ones—grateful that I was still alive and that I no longer needed to use.

Before recovery, I felt that the universe owed me something, but I had nothing I deserved. Using made life bearable. It started in my teens with the classic progression—booze, pot, pills, and eventually, cocaine and heroin. I spent 18 years on methadone programs, as I continued to use heroin. Methadone was supposed to block the opiate high, but all it did was make my life a little more stable, while, at the same time, keeping me connected with people who were actively using.

I always wanted to blame my parents for my addiction, particularly my father. I grew up poor, in the Brooklyn housing projects. My parents were uneducated immigrants from Mexico who gave me mixed messages of despair and hope. My father was an abusive alcoholic, who, in the depths of his drinking and misery, would sit at the kitchen table and cry that no one “understood” him. I thought it was the most pathetic thing in the world—a grown man feeling sorry for himself and crying about it. I swore I would never end up like that.

But many years later, I found myself in the same place. I was working as a night porter in a building on the Upper West Side of Manhattan, taking out the garbage and mopping floors. My life had become a series of failures, and I hated myself for it.

Then, at the age of 45—after 16 years of marriage to another addict, and after having a son born to this disease—my wife asked for a divorce. I was terrified; I did not know how to live life on life’s terms, nor on my own.

 I called a friend who was in a twelve-step program and agreed to join him at an N.A. meeting; I listened to what was said and decided to give it a try. By talking to other addicts, I soon discovered that I was not alone. They became my support system and we learned from each other through our shared experiences. It took a year to get off of methadone, with the help of the program I attended.

Gradually, I began to change my thinking. I realized that no one owed me anything, and if I wanted something—including self-esteem—I had to work for it. Today, I’m pursuing dreams I thought were lost forever. I always wanted to be a filmmaker because I loved to tell stories, but I never graduated from film school. I now know that I can go back to school and get my degree. In the meantime, I can continue to tell stories through my writing; I’ve joined a writers’ workshop, which has become an important part of my life. 

Most importantly, I’ve learned how to be grateful for what I have, rather than resentful for what I don’t have. I am now married to a lovely woman I met in recovery, and I was able to care for my father for the last years of his life without bitterness. I have a wonderful relationship with my son, who has never had to hear his dad talk of self-pity. For this, I am truly grateful.              

People rarely ask me why I drank, which shows either great self-control, or (hopefully) a greater understanding of the disease of alcoholism. After all, I drank because I drank, because I am an alcoholic. I would argue (given family history and upbringing) that I stood a 90% chance of becoming an alcoholic, like my mother, my grandfather, and my ancestors before me. But I did notice a steep dropping off point (jumping off is too optimistic) once I became a mother of twins.

Like any good alcoholic who hasn’t yet exhibited the heavy drinking, denial, and troubling proclivity for daily hangovers, I’d been able to drink fairly normally in my 20s. I could take it or leave it and often did, for weeks at a time. Nor did I typically binge in between (though exceptions did occur). 

But after my daughters came along, there was a perfect storm that provided all the kindling my little match fire needed to rage. I was lonely, in a troubled relationship, with a partner who was laid off two weeks prior to the twins’ birth. Plus, I was plum worn out. Like most parents, I tripped into parenthood singing a melody of hope and love, but was very quickly side-lined by the grueling reality of little to no REM sleep and the babies waking me up every 90 minutes or so.

I couldn’t go anywhere—not even to the grocery store—without some major production with formula, strollers, crying babies, and total hassle. Stuck at home, the only outlet I could find, aside from bad mystery novels, was a glass of wine in the evenings. White, crisp, tasty wine in a glass, while sitting in my reading chair devouring the latest book, after the twins were in bed was my idea of sheer heaven. So heavenly, in fact, I very quickly decided two glasses would be even better, and three better still.  In about two months, I was easily drinking nearly a bottle of wine a night. And it didn’t stop there.

Fast forward three years, and I was missing my daughters’ school events, having an affair, missing work, and living miserably from one afternoon to the next. Drinking took over, and you, I’m sure, know the rest.

Are mothers today under more pressure than our mothers before us? I’d have to argue yes. We’re charged with raising healthy, happy children, bringing home a significant portion if not all of the family income, and looking 20 years younger than our actual age. Given that many of us also walk through divorce, job loss, and single parenthood, in my view, it’s amazing we’re not all alcoholics.

I found my way into recovery after I finally told my brother Mark what was really happening in my life. I guessed correctly that he’d be supportive, but I hadn’t counted on him telling me to go to an AA meeting that day. In fact, he told me he’d call me later that evening to make sure I had attended.

Because I listened to him, I am now a proud, sober mother who brings her kids to my meetings when they’re not in school. Recovery has involved getting to two or three meetings a day, finding a sponsor, and working through the steps with other alcoholics. Without that multi-pronged approach, I’m quite doubtful I’d have two years sober today.

Motherhood did not cause my alcoholism, but it did provide the circumstances for me to succumb to its grips. I now believe our recovery efforts should be directed to the place in society where women, always striving for perfection and never measuring up, are trying—often alone—to rise up and raise up our next generation.

In recovery, we can find an antidote to these pressures, and even more, we can find a sisterhood of loving support, such as we never dreamed of finding.

Rachael Brownell

 For information about Phoenix House’s programs for mothers and children, please visit our New York or California pages.

On my first visit to Phoenix Academy twelve years ago, I remember the school’s secretary laughing after I asked what kind of private school it was. I wasn’t familiar with the program and, with its pleasant entrance and unusually peaceful atmosphere, it didn’t look or sound anything like the large public schools where I’d taught in the past.

We started playing a guessing game, until she finally explained that the school served students who were recovering from drug and alcohol addiction. It wasn’t a private school, she told me, but they were fully accredited and the class sizes were small—a maximum 17-to-1 student-to-teacher ratio. Wow, I thought, this would be a challenge.

When I came back for an interview and tour, the principal assured me that teaching at Phoenix Academy would be a rewarding career with the at-risk school population in Los Angeles County. What I really got was the opportunity to re-charge my teaching career, change some attitudes about education, and make positive contributions to the communities, families, and students I serve.

Every year, several of my students ask, “Why do you want to teach drug addicts, anyway?” My response is not simple and sometimes causes me to get a big lump in my throat. I teach at Phoenix Academy because I believe I am part of an organization that offers at-risk youth the second chance they so desperately need to get their lives back on track. I am constantly reminded that the challenges I faced growing up in a small town in North Dakota in the 60s and 70s pale in comparison to what my students face every day. The family difficulties, pressure from peers, and access to illicit and dangerous drugs require them to develop a strong character, resilience, and a positive support system to survive.

Despite these struggles, I’ve learned at Phoenix Academy that every student has the potential to accomplish something great and worthwhile—and my job is to help them find it. As I tell my students, “You may feel like everyone else in your life has given up on you, but I’m not going to give up on you.” To convince them that I was really serious, when I first started, I learned the Phoenix House philosophy—words that they must recite at least twice a day—and delivered it in front of my class. One of the kids got up and presented me with a dollar bill, which I’ve kept to this day. That token of their faith in me—along with the letters I’ve received from former students and their parents—are the fruits of my labor.

Through the years, I’ve witnessed the transformative power of an effective drug-treatment program—in combination with a supportive and responsive education program. Just as traditional approaches to education do not work with every student, not all drug treatment programs work with every client. But the therapeutic community concepts of taking responsibility for your actions, being held accountable, working as a team, and showing concern for others are successful techniques in helping my students live sober and productive lives.

Watching a student make better choices, problem solve, and rise to the challenge instead of running away from adversity is powerful and inspires me to look forward to each day on the Phoenix House campus.

Now, whenever a new student asks me why I do what I do, I think of the following quote from Rep. G.K. Butterfield (D-North Carolina):

“A second chance means an opportunity to turn a life around—a chance to break the grip of drugs…[A second chance] is the humane thing to do.  It is the responsible thing to do. It is the right thing to do.”

A recent study by CASA, Columbia University’s National Center on Addiction and Substance Abuse, found federal and state spending on health care for drug, alcohol and tobacco abusers totaled more than $200 billion a year. A fraction of this money goes to treating addiction and promoting recovery, while the lion’s share is swallowed up by treatment of the many acute and life-threatening conditions caused by the disease. A federal study found 1 out of 14 hospitals stays each year — which account for 2.3 million admissions — are directly related to drug or alcohol abuse alone. 

Not only are substance abusers costly health care consumers, so are their children. One study found children of cocaine users incurred three times the health care costs as children of non-using parents. Another study, examining neonatal health care costs in one hospital, found that costs for newborns of women who had used cocaine during their pregnancies averaged $5,200 more than costs for infants who had not been exposed to the drug.

 Suppose we addressed the cause rather than the effect and invested in appropriate addiction treatment for the estimated 23.3 million substance abusers who need treatment but don’t receive it – and whose addiction will ultimately cost us more?  We now have a wealth of proven, evidence-based programs and practices that deal with substance abuse as the chronic condition it is. Can they bring down the cost of health care? 

They can and they have.

 A California study found that the total medical costs for men who received substance abuse treatment dropped 26 percent, while their in-patient hospital costs and emergency room bills came down by 35 and 40 percent, respectively.   

With substance abusers making up about one eighth of the nation’s Medicaid population, it seems logical to increase what we spent treating the disease, and, in so doing, reduce the enormous economic burden of treating the symptoms.

If you saw my mother and me today, you probably wouldn’t guess that I didn’t really know her until I was a teenager.

When I was four, she made the most difficult decision a parent can make. Battling addiction, she realized that she couldn’t raise me in the way she felt I deserved. For my own wellbeing, she decided it was best that I leave her care and live with my paternal grandparents.

For the next ten years, I saw her only occasionally—even though we lived not too far from one another in Brooklyn. I didn’t resent her (from the beginning, my grandparents taught me that she did what she had to do), but at the same time, we didn’t have much of a connection.

It wasn’t until I was in high school that we began to form the close relationship we have now. By then, she was clean and had started working at Phoenix House. She reached out to me and we began seeing each other more frequently on weekends. If it weren’t for Phoenix House, I wouldn’t have her here with me today.

At 23, I’ve pushed the rare flashbacks of my parents fighting to the deepest parts of my brain—and instead, focus on the wonderful memories my mother and I have worked so hard to create. I think of the volunteering I’ve done with her at Phoenix House—where I’ve had the chance to see the incredible work she does. And I think how much I’ve enjoyed getting to know her side of the family.

Through the years, we’ve come to an understanding. I am who I am and she can’t do anything to change my ways, so she only gives me encouragement and support with all of my endeavors.

Most of all, I appreciate the important lesson she’s taught me: with patience and understanding, a person can truly get through any hardship. It doesn’t hurt to have a little faith in God as well.

My mother’s name is Joan, so I always make the association with Joan of Arc. She’s the best candidate to be chosen as one of the twelve OASAS Spotlight Stories. While addiction is a vicious, chronic condition, she has taken control of her disease—and come out on top.

I have been in the substance abuse field for over 20 years, first as a treatment provider and then as a researcher. But it is through the eyes of a person in long-term recovery who has buried family members and close friends (one who was sober over 17 years prior to relapsing) that I understand the battle DJ AM faced.

Recovery, no matter how many years one has nurtured it, is never fully self-sustaining. It needs continued attention and dedication, just like any other chronic health problem. So, I ask, can someone in recovery ever be 100 percent confident they will not go back to drugs or alcohol?

Last year, DJ AM suffered critical injuries when a Learjet carrying him burst into flames during an aborted takeoff in South Carolina. He and Travis Barker of Blink-182 were the only survivors. After more than a decade of clean living, he found himself needing pain medications with abuse liability; he reportedly developed problems with opiates and benzodiazepines.

Then, he shot MTV’s Gone Too Far—an intervention-style reality show set to premier on October 5. He said his inspiration was to work with other addicts in recovery, his passion since the beginning of his sobriety.

I, like DJ AM, believe it’s important that people with past addiction problems commit to helping others. But he may have truly “gone too far.” The drug-using world might not have been one he was prepared to re-visit, given his recent losses and difficulties with pain medications. “I have to calm down after every shoot,” he was quoted as saying. “It’s very intense.” In video excerpts, he described buying a crack pipe to show how easy it was. Then he said, “I walked out…holding [the pipe]…and I realized my palms were sweaty and I was like, ‘Wait a minute, this is not smart for me.’”

Even after 11 years of sobriety, this isn’t unusual. Ask any one of us in recovery when someone inadvertently changes the TV station and a scene from Scarface shows a group of people snorting cocaine. It’s been over 24 years since I’ve snorted coke, but suddenly, I’m holding my breath—as if I’d just done a line.

So, should DJ AM have done the show? Is MTV at fault for his relapse and death? Here’s the bottom line: Just as people with diabetes are responsible for eating a sensible diet and exercising, we are also responsible for managing our recovery. But, just as the spouse of a diabetic assists their partner in managing their illness, we need people to help us, too.

Based on my research, my clinical background, and my own recovery experience, if I had been DJ AM’s friend, I would have told him, “Examine your motives. Think ahead to any emotions that might arise. Make plans to have the folks who support your recovery nearby when you’re taping and after each session. Talk to them, tell them what you’re feeling, and renew your commitment to your recovery each night. Most importantly, promise you will call me before you pick up a drink or a drug.”

And if I had worked for MTV, I would have advised them, “Make sure DJ AM has someone with him during filming—a long-term recovery mentor who knows him well and will help him process any cravings. Don’t ask him if the show is bothering him; he might be the last to notice it.”

 We have to wonder if this type of support might have saved his life.

This Saturday, September 12, I will think of him when I represent Pennsylvania as the state delegate at the A&E Recovery Rally—one of the key events for National Recovery Month. An expected 10,000 of us will march across the Brooklyn Bridge. I will walk in memory of my stepson, who died of an overdose just 15 months ago at the age of 30, and my old friends Mark and Mike, both of whom lost their battles with addiction.

 And I will walk in honor of DJ AM, who wanted so deeply to offer those in recovery meaningful support.

 It’s now up to us to carry his mission forward.

The great strength of “The Cleaner” is the show’s ability to dramatize the downward spiral of addiction, showing how drug misusers “get stuck,” and the difficulty they have of getting “unstuck.” In life, as on TV, an “intervention” is often the means of “unsticking” someone deep in drug misuse. Interventions may indeed be as dramatic as kidnapping or substituting sugar for the user’s drug of choice. But, while bringing together a team of “significant others” to “confront” the user makes for good viewing, it actually occurs rarely. There is an extraordinarily broad range of intervention strategies and they are employed every day in any number of different venues—family dining rooms and kitchens, therapist’s offices, business offices, factory floors, lecture halls and hospital emergency rooms.

The process of getting the drug misuser “unstuck” can begin in any one of these settings—but it only begins there. An intervention just starts the process, because getting unstuck requires serious engagement of the individual in a program of treatment responsive to his or her unique needs—a process pursued in an appropriate setting and involving others. These others may be trained professionals. They may be men and women with similar histories of drug involvement. A community of faith may be a critical part of this recovery process, as well as friends and family. Medications may be involved, cognitive behavioral therapies, prayer, hope, encouragement and opportunities to learn about oneself and master the skills needed to offset the long-lasting craving that comes with addictive behavior.

In short, while “intervention” may be as dramatic as those of “The Cleaner” or—as is more often the case—slow and guided, what counts is what follows!

We at Phoenix House have learned that what follows is a process of learning how best to achieve lifestyle change and continuing recovery. It is a process that varies from person to person. Each day, Phoenix House cares for more than 7,000 people in various settings and stages of recovery. We pledge that each receives the help he or she needs and each is treated with professionalism and respect. We recognize differences in need and our service delivery continuum is designed to respond to these differences. And, while “The Cleaner” deserves our applause, viewers also deserve to know that, no matter how getting unstuck begins, the greater need is for the rest of the process, which is what most of our field is there to provide.

David A. Deitch, Ph.D
Chief Clinical Officer, Phoenix House