Addiction kills, everywhere

Philip Seymour Hoffman; CVS eliminating tobacco products from its stores: the week’s news has circled around addiction. Addiction to opiates (or amphetamines or cigarettes or alcohol) shortens life expectancy, and corrodes quality of life for the addict and his/her family and friends.

In the old days, “hard drugs” like heroin were associated with urban life. Then meth labs sprouted up around middle America and in recent years addiction to opiate-based pills recognizes no geographic boundaries. And, because of the high street cost of those pharmaceuticals, heroin has made substantial inroads onto the back roads of rural America.

The recovery rate for addicts–whether to drugs or alcohol–is virtually unknown. In the case of people who seek help through AA or related organizations, rules of anonymity preclude long-term tracking of abstinence. In the case of other treatment methods, self-promotion and economic considerations (as in the case of private treatment centers) make statistics questionable.

Years ago, a friend of mine who is a substance abuse counselor, and who is himself a recovering alcoholic and heroin addict, told me the sad, rarely discussed truth about recovery: the long-term success rate is far below the numbers we usually hear. In fact, he said, the most optimistic we can be is that about 20% of alcoholics and addicts actually quit for good, and that age and social circumstance play a big role in success. So, perhaps 30-40% of people in fairly stable family and work situations within the 45-60 years old age range may succeed. But the rate may drop to only 5% for teenagers living in unstable circumstances.

I have friends dealing with teenage and twenty-something children who are struggling with serious addiction problems. In the North Country. We all need to help and support people we know who are dealing with this anguish. It could happen to any of us.

Staying straight for six months, six years or even decades, as Hoffman did, is not an indicator of a “cure.” Once an addict, always an addict. One day at a time is a meaningful mantra.

Hoffman’s death underscores the challenge of dealing with addiction. A blog post at Slate by Seth Mnookin brought home for me why Hoffman’s death seemed to touch so many people so deeply. He had it all: family, fame, money, recognition by his peers. The power of addiction is terrifying.

So what do we do, as a society? as family members? as a friend of an addict? Should there be more universally available resources and centers for treatment? How do cost-benefit ratios shape our public decision-making?

For me, it always boiled down to this: once you have a child or a close friend or family member who has struggled with addiction, it takes years and years after the addict gets “clean” to trust that the addiction has been beaten. Philip Hoffman’s story shatters that assumption, that sense of success. It’s not that some former junkies and drunks don’t get beyond their addictive cravings (I certainly haven’t thought about having a drink in years and years). It’s that it’s a bit of Russian roulette: we just don’t know which recovering addicts may still be vulnerable. And, if they’re  vulnerable, everyone around them is, too…even strangers, as in the sadness Hoffman’s death caused for so many Americans.

Your thoughts and stories welcome and appreciated.