UncategorizedMay 27, 2020
We can’t solve this persistent and complex problem without identifying reasons why there has been little success in curbing America’s appetite for drugs and alcohol. We need a new way of thinking.
By Lisa Boucher
To win a war, you need to understand your enemy, but there’s too much our society doesn’t understand about drug and alcohol abuse. Alcoholism and drug abuse is a multifaceted problem that needs a multifaceted approach. We can’t solve this persistent and complex problem without identifying reasons why there has been little success in curbing America’s appetite for drugs and alcohol. We need a new way of thinking.
After living with an alcoholic mother, becoming alcoholic myself and sobering up 27 years ago, plus working 24 years in health care, it’s fair to say I’ve learned a few things about the disease of alcoholism and addiction and why society fails to make a dent in restoring wellness. I’ve identified four areas where if serious change were initiated at each level in a few decades we may see a decline of this problem in our society.
Parenting is key. Stable homes and neighborhoods are crucial. The one thing that kept my family from becoming a statistic was that my father was not an alcoholic. He was employed and stayed employed and didn’t leave my mother even when he had every reason to bolt out the door. Children who are raised in homes where parents liberally imbibe or use drugs have little chance of not falling into the same trap. Parents who are addicts, whether rich or poor, cannot teach their children effective coping skills. Fear is always a factor in these homes because of the predictable unpredictability.
Lack of education, resources, family support, coping skills and the presence of violence all contribute to a perfect recipe for cultivating future addicts. Parents addicted to drugs or alcohol often end up divorced, and some disappear altogether from their child’s life or fail to contribute financially.
None of these actions are singular, and they have a ripple effect: A child will internalize a parent’s disappearance or lack of involvement, his internal voice will convince him that he is not worthy or loveable, then his self-esteem plummets. If he has even the slightest genetic disposition to alcoholism or addiction (as so many of us do who have a parent or parent with the disease), those feelings of inferiority are often the catalyst that drives him into finding something, anything, to quell the raging storm of feelings. Once a child finds that something to change the way he feels, he will be hooked, and he will chase that feeling until he dies or finds recovery. This is the harsh truth about family that society needs to understand because we continue to cultivate addicts and then lament at the problem.
Foster care is the second arm of the problem. Parental instability often leads a child to end up in foster care. It’s been my experience that most kids end up in the system because of their parents’ drug and alcohol abuse and only sometimes because of mental illness.
As the heroin epidemic continues to grow in the United States, more and more children are being forced into foster care, and it often looks something like this: Senior citizens looking to supplement their incomes sign up to be foster parents. Sure, they may be good people, but as a nurse, I have watched one too many of them come to the hospital on behalf of the child with disinterest smeared on their faces. I have witnessed eye-rolling, texting while the nurse gives discharge instructions, fidgeting, sighing — the disconnect between child and caregiver is palpable.
Some foster parents appear so feeble they seem to need assistance themselves, while others lack resources such as reliable transportation. These foster parents may mean well, but how well do they parent? We have reduced childrearing to a task that “someone has to do,” when there are people who spend more time, energy and attention shopping for a living room couch than they care to expend on raising a child.
Furthermore, foster care case managers are overwhelmed by heavy caseloads. They do the best they can, but it’s not enough. Our kids deserve better, and these professionals deserve better incomes and support. Again, the ball is dropped in the health care system because shuffling children to different homes doesn’t bring in the income that quadruple bypass surgeries do.
Too many foster homes provide the physical necessities but neglect the emotional and developmental needs of the child. I’ve met many 14- and 15-year-old kids in foster care who can’t read and can barely write. In every way, their parents have failed them, the schools have failed them, the courts have failed them and then the foster system fails them. How can anyone be surprised when these children turn to gangs to find acceptance and turn to drugs and alcohol to numb their shame, their confusion, their pain and their loneliness? And, let’s not forget the all too frequent reality of abuse that happens in some foster homes that further guarantees that child will seek something — anything — to numb their pain.
We’ve been cultivating addicts for years, and no one wants to acknowledge the root of the problem because if we do, then we have to make changes, and that seems too hard of a task. When kids in the foster system are raised without stability, structure or love, when these kids don’t get an education or receive guidance about post high school options, they can’t move on to become productive members of society. Instead, we cast them out of foster care and into dependence on public assistance where they often stay for the rest of their lives without support or encouragement to do otherwise. How could they not? No guidance. No support. No resources. What 18-year-old aging out of the foster care system has the emotional, intellectual or financial resources to hit the ground running?
Health care has two landscapes: There’s the view you see when you walk into the cardiac tower with gurgling waterfalls, marble floors, plush waiting area couches and seats, with men and women moving about in starched white lab coats — and then there’s mental health.
Mental health is rarely a money-maker for hospitals, which is why so many facilities have been closed in the past decades. But are we saving any money? I can’t see how. We’ve just moved the expense to another budget.
In many cases, people with addiction issues and mental health issues receive the exact same treatment. Doctors need more education to recognize that people with addiction issues do not need and should not receive antipsychotic medications. I’ve seen far too often doctors who dole out Seroquel XR® and Abilify® to all.
What physicians don’t understand is that an addict or alcoholic will welcome a mental health diagnosis — such as bipolar, major depressive disorder or anxiety disorder — because these diagnoses give them a clear path to disability checks and an excuse to continue their drug and alcohol abuse. I’ve talked to many recovering alcoholics who later chuckle about their previous mental health diagnosis, while others are angry at the medical community for the misdiagnosis that allowed them to stay stuck in their addiction.
The only way some were able to escape is because of a family member or friend in recovery who knew what was happening and said enough, or they encountered a professional along the way who understood the disease of alcoholism and offered them rehab or pointed them to a 12-step program. For that scenario to work, however, the patient has to want change and they have to be sick and tired enough of their life to want to try something different.
My late mother is an example of an addict who suffered at the hands of the medical community. She was diagnosed with manic depression disorder (MDD), and during her decades-spanning stints in the psych ward, she was prescribed heavy-duty antipsychotics such as Thorazine and lithium, a mood stabilizer used to treat mania in people with bipolar.
My mother wasn’t mentally ill — she was an alcoholic. She wasted almost 20 years of her life being treated for MDD. It wasn’t until she fell down the steps and broke her neck that she finally crossed paths with a physician who recognized her for what she was. My mother was placed in rehab and got sober. She died after 30 years of clean living, taking only medication for blood pressure and a thyroid medication, during which time she helped hundreds of women through their addictions.
What happened to my mother in the 1970s and ’80s continues to happen. People are misdiagnosed, they receive medications they don’t need and they’re robbed of the opportunity to find sobriety.
I currently work in the mental health field, and I am disheartened by the number of people trapped in a broken system that enables the patient to stay sick.
One of the biggest offenders of enabling on a corporate level are the managed care companies that handle Medicaid patients. Some offer unbelievable services and liberal mental health stays. They are far more liberal with the number of allowable days they will pay for inpatient services. The difference in allowable time between the managed care companies and private insurance companies is startling.
Why do we have managed care companies that offer free rides to addicts who end up in a different city only because they aimed to score drugs? One woman was 90 miles from her home when she came to buy heroin. Her group of friends all scattered, and she was left stranded. She called her managed care company, and they arranged to drive her 90 miles back to her home after she rested up a few days in the hospital.
The enabling has got to stop. Addicts and alcoholics joyously take advantage of these services while they are on disability for their “anxiety and depression” when in fact they are drug addicts who know to say “I’m suicidal” when the heat is on.
Oh, do I sound dispassionate? Where’s the compassion for the children and families who are wrecked by this behavior enabled by the managed care companies that are supposed to be in the health and wellness industry?
Our system is broken. Lives are ruined, and the only solution is to open our eyes and admit our health care system is peppered with addicts and alcoholics who doctors can’t recognize and don’t know how to treat. Until we learn to recognize the manipulation and the devastation, we will continue to cultivate more addicts and enable the ones we have to stay stuck in their disease.
Lisa Boucher is the author of Raising the Bottom: Making Mindful Choices in a Drinking Culture (She Writes Press, June 2017). She holds a bachelor of arts in English and is the mother of twin sons, now grown. After short stints training polo horses, working as a flight attendant, hairdresser and bartender, she revamped her life and settled in as a registered nurse. For the past 27 years, she has worked with hundreds of women to help them overcome alcoholism, live better lives and become better parents. Raising the Bottom is her fifth book. Boucher lives in Ohio with her husband.