In addition to my regular position, I have been working part-time in a psychiatric hospital's admission department for almost the past three years. I do assessment interviews and then consult with a psychiatrist by phone whether or not the patient meets criteria to be admitted to the hospital.
I have interviewed hundreds of patients who are wanting to come in to "detox" off of either Alcohol or Heroin. It is like I am watching a lot of people die and their families suffering. It is my window to the world of suffering.
The Worlds of Addicts
I sometimes get a patient who has a blood alcohol level of .240 or higher who is beginning to go through detox symptoms already. This person is drinking hard liquor such as Vodka or Whisky to the tune of one pint to one fifth daily. The significance of this is that the person is three times the legal limit of blood alcohol and thoroughly drunk but the body is ironically saying it is dependent and craving more Alcohol to stop the detox symptoms. There are people who die of alcohol poisoning (a BAL of 400 or higher) or other alcohol-related disorder because they have to drink more and more to feel drunk or to stop from going into detox and they go over the cliff of .400.
My experience of the Heroin addict is somewhat different and I have pieced together the average process. From what I can tell this stuff is expensive and addicts have to engage in all manner of illegal activities to keep the money flowing to get the next hit. Many started out with pain pills and when the pain pills run out, they moved to Heroin. They first snorted or smoked Heroin, but the vast majority of them go straight to injecting it for the full effect. They need more and more of it because their body develops tolerance and they have to avoid detox. I hear a statistic from time to time of how many people die of Heroin overdose in my home of Louisville, Kentucky USA, and I wonder how many of them I met?
The majority of Heroin addicts are homeless. They are unable to hold down a job because being high or going through detox. They have stolen money, cherished items, and anything else that can be sold quickly from almost everyone in their healthy social network and estranged themselves from families and friends. The drug has cost them everything.
I have met Heroin addicts who are good actors. One guy I interviewed sounded and looked like he was going through detox and I got him accepted by a doctor and a bed in the hospital. When he learned that his girlfriend was not being admitted, he immediately said he wanted to leave. I saw him after the interview in the hallway and he looked normal as without detox symptoms. It seems that Heroin addicts lose themselves in their slavery to the substance.
Heroin addicts tend to engage in a chaotically bond with other Heroin addicts and they collectively engage in a pursuit of the drug. They hustle and prostitute themselves. They shed their dignity for the next hit when necessary such as a lesbian prostituting herself to men. They share drugs, needles and blood-borne pathogens such Hepatitis C with each other. They are traveling along the road to death.
From what I can tell, the average addict has at least one criminal charge. Many of them have felonies that will disqualify them from getting many well-paying jobs and rental properties in which to rebuild lives and repay debts.
The addict wanting to be in recovery almost has to move heaven and earth to get back in a stable situation. In most locations the resources are stretched to the limit. Halfway houses have no room. The newly detoxed addict needs a lot more to maintain absence and sobriety than what it available. Furthermore, the family they would otherwise depend on for support will logically not trust them because of all the dishonesty and perfidy. For the repeat patients I have interviewed more than one time, I have not been surprised that they relapsed because it presents as their only option.
Somewhere in here I should mention Marijuana. There are lot of proponents of legal marijuana. I am not one of them, While it does not always have the severe symptoms of Heroin and Alcohol, I am seeing how it is distracting kids from school and parents from their kids. It too causes problems.
The Family
We typically think about the family member of the addict more than the addict. I occasionally have a family member come with an addicted person. Most family members have been burned out or exploited by the addict to the degree that they have kicked the addict out and will refuse to the addict come home.
Many family members tend to be both mad and sad because of the addict. The addict is not getting his or her act together. The addict is not listening. The addict keeps blowing it and the cycle repeats. Many family members still love the addict and the pain is real.
Parents of addicts struggle with guilt. I have had older adult patients lament how their adult children messed up and ended up in jail.
Children of prodigal addicts are left with voids in that addicted fathers or mothers do not come around and do not call. They are torn between anger and longing for a relationship with the parent. Many children hold out a hope that the missing mother or father will come and fulfill their emotional longing and emptiness.
Otherwise, resident alcoholic parents are stale potato chips. They are drunk, hungover or emotionally unavailable. The alcohol parent raises a scapegoat, comedian, lost child, and wonder child who all survive the situation.
Surviving Christmas: Coming to Believe
The pain of addiction can be amplified at the holidays. As our society has the ideal that all of family is supposed to together at Christmas. While many of us will have to deal with a drunk family member, the absent, addicted family member is the spoiler for many of us.
Some of us who very angry have unequivocally resolved that we will not miss them. Some of us still have a tender spot for the addicted family member because we still see the good in them and have good memories with them. There will possibly be arguments when family talk about the prodigal addict.
The addict is symbolic of the need for Christmas. The world in and of itself is lacking serenity and is powerless over sin and it has become unmanageable. The question is will people come to believe that a Power greater than all us could restore us to sanity?
The religious icons of Christmas are everywhere, but do people believe? The baby in the manger grew up eventually, had, and still has the power to make a way for people to have peace, salvation, and serenity.
Even though some of us may have our holidays marred by the existence of a prodigal addict, there is still peace and joy that can be felt at Christmas. The power of the babe in the manger seems to be made most real in our weakness because we cannot do it on our own.
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