Chapter 1: Opening Pathways and Breaking Down Barriers at Home and In the Legal System

I began using heroin when I was 26. First drug I’d ever tried. Not your typical story, but then, everyone’s story is different. So, too, is everyone’s path to successful recovery.

Within 4 months, and realizing I needed it every 8 hours just to keep away the heebie jeebies, I looked for help. I went to my family, thinking they could help me get back on track. That was a mistake.

They meant well, but they didn’t know where to begin. So they turned to the Internet, which offered nothing useful and plenty that reinforced dangerous myths that derail people like me from seeking treatment in the first place. Mom wanted to send me to inpatient rehab for 6 months, which I refused to even consider.

After that I went to my doctor (because I had a good job and insurance, something many of us don’t have). I asked about methadone and Suboxone, but instead the doc wrote me a prescription for trazodone and wished me luck. I was back to using within two days.

Two years later I called a methadone clinic, despite the stigma tied to methadone maintenance treatment and the promise from my mom that she wouldn’t support a “legal heroin” habit. The intake fee was $175, which equaled about three days of using at the time. Needless to say, I never made my intake appointment.

I tried outpatient programs, inpatient programs, and went to countless twelve-step meetings, both willingly and by court order. Twelve-step works for some people. It never resonated with me. In fact, I feel like some of what I learned there (especially about relapse) helped me sabotage several later attempts at recovery.

It wasn’t until I met my spouse that I found someone willing to support me in my recovery on my own terms, with help and guidance when I needed it. She urged me to stop using, but didn’t set strict rules. Within a couple weeks I was in a methadone program.

Methadone-assisted treatment was a game-changer for me. I don’t hesitate to say it saved my life. It wasn’t the “liquid handcuffs” I’d been promised by so many people who failed to comply with their treatment and later went back to using. It didn’t eat away my bones or make me gain 300 lbs. It was medicine and I took it in a clinical setting, which changed the way I thought about using and took away the rush I got from finding ways to get drugs every day — which was a good thing.

I slipped a few times. When I thought I could get around a drug test, I would use occasionally. But a few months into it, I stumbled into SMART Recovery. SMART is an evidence-based alternative to twelve-step programs. It clicked with me from the start. The greatest benefit was that it taught me when I did slip up and used once or twice, I didn’t have to start over at the beginning (“here’s your white chip” as he surrendered once again and hung his head in shame). As long as I kept moving forward and worked to address what caused my slip, it wasn’t a big deal; which took a world of pressure off my shoulders.

Eventually I switched to Suboxone, which carries less stigma, but is still considered “trading one drug for another” by detractors and, especially, by many journalists and politicians who unfortunately still have a lot to learn.

It was then that a therapist suggested I seek treatment for mental health issues. In all my twelve-step meetings, stays at rehab, and encounters with “addiction specialists” not once had anyone suggested something so obvious.

Now I’m getting the care that I need. I’m still on Suboxone and I have no problem accepting I might be on it the rest of my life. It’s medicine for me and, to be frank, I don’t give a damn about the stigma people attach to it. That’s their problem, not mine — but it is a barrier we need to eliminate for other people seeking help.

My story is my own, but there are thousands just like it. Statistics show that when those who misuse substances find their way to recovery, they do it on their own terms, not when they’re coerced by courts or forced into it by families with interventions or a misguided “tough love” approach.

With that in mind, what can we do to tear down those roadblocks that make getting treatment so difficult? I spent ten years trying to quit heroin, and for most of that time I sincerely wanted to stop. The problem was I didn’t know how — and the folks who wanted to help me didn’t know how either.

To break down those barriers we need at least these three things:
1. We must eliminate the stigma around medication-assisted treatment (MAT). MAT is the most effective method for getting opiate users to reduce the harms associated with their use and to take positive steps toward healing. That’s proven.

2. We need effective educational materials that are accessible, appealing, and easy to follow. When someone finds out their child, spouse, or friend is using, how do they approach the situation? How can they be supportive? How can they keep their loved one alive until they’re ready for help? There is an evidence-based family therapy approach–Community Reinforcement and Family Training (CRAFT)–proven to be an effective intervention, based on compassion and the strengths and resources of families, and empowers family members to take care of themselves and the safety of their family

3. We need to break down barriers to treatment. Most heroin or pain-pill users won’t spend 200 bucks to enter a methadone program, then spend $12 to $20 a day just to not be sick — especially with the stigma and myths that exist. Some methadone clinics are great (I went to one) and some are awful. How to we establish standards that don’t create more barriers? If medication-assisted treatment is readily-accessible, I believe (and statistics likely bear this out) those with substance use disorders who do want to quit will find their way into them.

From a policy level, let’s get this out of the way first: “Nothing about us without us!” If you’re going to make laws that affect drug users, you need to include us in the process. We’ve been excluded for decades and that’s part of the reason our system is so awful now. We’re people. Our lives matter. And we’re a helluva lot smarter than you give us credit for.

Furthermore, how do we make lawmakers see that this is a problem that affects us all? Drug use can lead to property crime, which leads to jail, and probation, and prison, and more drug use, and more crime, and so on. Even if we don’t know someone who’s using, we’re paying a price for the failed “War on Drugs.” Members of groups like FSDP are empowered to use our collective energies to push drug policy toward a treatment-based model, not the punitive, prison-based model that’s given our country the world’s highest incarceration rate.

That’s a lot to take in, but we have a lot of work to do. I don’t have all the answers. None of us do. But I do believe that when we put our minds together, and put our thoughts into action, we can make changes that save lives and keep our friends and loved ones off drugs. I’ve seen it happen and I know we can do it.

What do you think it will take and how far are you willing to go to make it happen?

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