High

by David Sheff

  At a school in Pasadena, a girl stands up. She’s wearing a black T-shirt and jeans with sequins running down the sides. Her hair is chopped short.

  She says she’s been smoking “a ton” of pot. Then she begins crying. “My father is a cocaine addict, and I’ve tried it. I’m afraid I’m going to turn out just like him.”

  There are more than a thousand students in the auditorium, but it’s completely quiet.

  She says, “I swore I’d never do drugs, but I tried them.” She’s sobbing now, and a group of friends near her come over and put their arms around her.

  We’re about to respond when someone else speaks up—a boy in another part of the room. He’s wearing a navy polo and wire-rimmed glasses. “I appreciate what you’re saying,” he tells the girl. “My father’s an alcoholic.”

  The boy is handed the microphone, and he keeps going. “My dad would never admit it,” he says, “but he’s definitely an alcoholic. When he comes home from work, the first thing he says is ‘I need a drink,’ and he pours himself one. Before dinner, he’s had three or four cocktails, and then he has a bottle of wine when we eat. Every night it’s pretty much the same thing. He gets drunk and then he watches TV and passes out. Everyone pretends we’re just a normal American family.”

  Another boy stands and says, “It sounds like my house. My parents say they’ll kill me if they ever catch me doing drugs, but they’re drinking, and look in the medicine cabinet: it’s a pharmacy. They take pills all day long—painkillers, Xanax, Valium, sleeping pills. They’re completely hypocritical. We were going on vacation, and we were at the airport and my mom realized she left her pills home and freaked. So we had to go back and we missed the flight.”

  One story after another. Kids living with addicted parents. Kids experimenting. Kids worried—or scared. It’s incredibly difficult for a kid to have a parent or parents with a substance-use disorder, and siblings of people who are addicted describe it as hell.

  After the assembly, the girl who told about her father’s cocaine use comes up to us, and we ask if she’s all right.

  “It’s a relief to talk about it,” she says.

  That’s the first thing to know—yes, it’s scary to talk about it. Some people feel shame, some feel anger. But we know from our family’s experience you’ll feel so much better after you do—because you’re no longer alone. And there’s something else: once you’re open, you can begin to get help.

  WHAT ABOUT YOU?

  For those of us with addicted family members, the first thing to keep in mind relates to your own decisions about drugs. It goes back to what we said earlier: because of a genetic component in addiction, you’re at a higher risk for drug problems.

  One girl wrote, “Because I knew that it can be inherited, when I started drinking a lot more than I’d planned, I thought, Oh, sh—. Maybe what they said is true. Maybe I could turn out like Uncle Robert, who drank himself to death.”

  She realized she needed help to stop using and sought treatment. Recently we heard from her again. She’s been sober for almost two years.

  COLLATERAL DAMAGE

  In families with addiction, the risk component isn’t just genetic; it also has to do with behaviors in the family. Kids learn from their role models, and parents and siblings have an enormous impact on a person’s behavior.

  When a kid sees his parents or older siblings drinking or getting high to cope with life’s stresses—or to celebrate its successes—he or she learns to see it as normal or maybe even expected.

  There’s also collateral damage. Growing up in a family with addiction is traumatic. Young people need stability and safety, and drugs bring instability and risk. Some young people growing up with drug-using parents are literally physically unsafe, emotionally unsafe, or both. They also have unpredictable mood changes. They can be angry, and they’re often afraid.

  “The one thing I could count on is that you couldn’t count on my mom,” one girl wrote to us. “I grew up not trusting anyone.”

  Another girl wrote, “Every night at home I would walk on eggshells, afraid, because I didn’t know if my father was going to be sober. If he was high, you never knew what would happen. Sometimes he’d yell and throw things. He’d embarrass me in front of my friends. Sometimes he’d just go into his room and I’d hear him crying. I don’t know which was worse. All those nights he was in there . . . I was always afraid he’d kill himself. I’d sit by the door and think there was something I should be doing. I thought it was my fault. I was too much responsibility, too noisy, not a good enough student, not enough help around the house, even though I did a lot. Sometimes I felt like the parent taking care of my father and mother and my little brother and sister.”

  A boy we met said, “I’ve watched my big sister have a seizure and OD in front of me. I’ve watched her be carted out of my house at two a.m. in handcuffs. She broke in to our house to steal money and food. I get a horrible feeling every time I think of her. When the phone rings, I think, Is this going to be “the” call? I get mad as hell at her, but I don’t want to lose my sister.”

  In many families, people become obsessed with the person who’s using. Parents can’t work or are distracted or apt to become angry or depressed. When a brother or sister is addicted, a sibling can feel abandoned and unsafe, and they can become angry, too—and then feel guilty because they’re angry.

  A scene from Breaking Bad puts a fine point on this when the addict Jesse Pinkman says to his brother, “You’re so lucky. You’re the golden child.” His brother’s response? “Are you kidding? You’re all they talk about.”

  A PAINFUL CYCLE

  It’s understandable that people try to hide drug use and addiction in a family. They don’t want to feel judged. Parents think others will assume they’ve failed at parenting (David did). Kids worry about being judged, too—they assume people will think there’s something wrong with them if they have an addicted parent or sibling.

  Once, someone who heard our story expressed bafflement that anyone in our family would become addicted, saying, “But your family doesn’t seem dysfunctional.”

  Of course, we’re as dysfunctional as every other family we know. Sometimes more so, sometimes less so. We’re not sure we know any “functional” families, if functional means a family without difficult times or members with problems.

  Like the addicted themselves, families are everything you would expect and everything you wouldn’t. We live in a culture that looks at drug use as if it’s a moral issue rather than a health issue. As a result, people try to ignore, deny, or hide drug problems.

  Once we understand that drug problems can affect any family and aren’t a sign of weakness or immorality but of confusion, stress, and mental illness, it may be easier to be open to getting help. We can stop judging and treat one another with compassion.

  What can you do if you have an addicted parent, brother or sister, or other family member? The first step is talking to someone. It’s a huge relief, and hopefully the person can direct you to help. Where? There are support groups and therapists who work with the families of people with addiction.

  HELP IS JUST A PHONE CALL AWAY

  Therapy is for kids of all ages: elementary school all the way through college. You don’t have to suffer alone with the stress of a loved one’s addiction—the fear, the anger, the confusion, the worry.

  When we suffer in silence with an addict in our family or with other difficult circumstances, our pain is worse. When we’re open, we suffer less. It often looks as though others are doing fine—they’re confident and happy; they’re sailing through life while inside you’re hurting. But no one sails through life alone.

  When we choose to stop hiding what we struggle with, there’s tremendous relief. We can be supported. We can get help. We learn that we aren’t alone. And we aren’t. We’re in this together. Life is hard. Sometimes it’s unbearable. Living in a culture where drugs are prevalent and addiction is rampant—when every day people are dying bec
ause of drugs—can feel overwhelming. But with openness and knowledge, we can move from darkness and suffering to light, hope, and healing.

  CHAPTER TWELVE

  Drug-Free: Treatment, Relapse, and Recovery

  I thought things could never get better, but they did, and when they did, something amazing happened. One day it hit me. It wasn’t just that I wasn’t wasting my life being high all the time. I was living. Like I had the kind of life I’d always wanted but never thought I could have. I’d found real friends, real hope, real love, real joy. —LILY (PHOENIX, ARIZONA)

  It’s been a learning process, I’m growing. I couldn’t believe that anybody could be naturally happy without being on something. So I would say to anybody, it does get better. —EMINEM

  Sobriety was the greatest gift I ever gave myself. —ROB LOWE

  ELIZABETH’S STORY

  In the living room of a stone house in a quiet neighborhood in the Chicago suburb of Oak Park, a fire crackles. The only other sound is sobbing.

  Joan and Richard Laurel huddle together on a couch. Joan is crying, and Richard puts an arm around her. He’s near tears himself.

  Joan whispers, “Our poor baby.”

  Richard looks at her with disbelief. “Poor baby? She’s out of control. For God’s sake, Joan, your poor little girl is shooting heroin!”

  Joan says, “I can’t send her away. She needs her mother.”

  “She hit you,” Richard counters. He looks at his wife. “What’s it going to take? It’s for her own good. We’ve gone over it a thousand times.”

  A chime. Richard rises, goes to the front door, and lets in a gray-haired man in a business suit and a seventeen-year-old girl hidden inside a peacoat—his brother and niece. She has bleached hair, chopped short, and dark eyes. Her father looks at Richard with sympathy and sadness. The brothers hug. Looking up at the girl, Joan says, “It’ll mean a lot to her that you’re here, Tami.”

  Another girl arrives: Bridget. She’s Richard and Joan’s youngest daughter. Earlier there’d been a discussion about whether to include Teddy, their twelve-year-old son. They decided it would be too confusing for him, so he’s spending the night at a friend’s.

  The door opens again, and a willowy girl with wispy blond hair enters and hugs her father. May, the Laurels’ eldest, is studying to be a doctor at the University of Chicago. She hugs her dad. When she finally pulls away, she has tears in her eyes too.

  The next to arrive, a man in his late thirties, circulates through the room shaking hands. “I know this is hard,” he says. Addressing everyone, Dr. Miles Grissom, the therapist hired to guide this intervention, says, “Let’s all sit down.”

  He leans forward, his elbows on his knees. “So Elizabeth will be here soon,” he says. “We’ve rehearsed, but that doesn’t mean it will be easy. Do your best to sit quietly. From experience, I can tell you what helps.” He looks around the room. “Breathe.”

  The door opens. The first one in is Richard and Joan’s other son, Mac. He’s broad shouldered and thick necked. He’s followed by Elizabeth, tiny and gaunt, with coffee-brown hair and uneven bangs, wearing a thigh-length gray wool jacket. Her black eyes flash around the room. “What the f—?” Her eyes bulge. “You gotta be f—ing kidding.”

  Elizabeth looks at her parents. “You motherf—ers.” Louder, fiercer. “F— you!” Then, as she turns, she screams, “F— all of you.” With his massive body, her brother blocks her exit. “Please,” he says. “Liz.” Tears stream down his cheeks, but he doesn’t move from his place in front of the door.

  Dr. Grissom convinces Elizabeth to sit down.

  Elizabeth sits in a chair, surrounded by her family. She looks down, staring at her hands. Sometimes she shoots the others horrified or angry looks.

  Dr. Grissom guides the family and comforts Elizabeth through the process. He assures her that everyone is there because they love her and are worried. He asks her to sit while those present read letters they’ve written to Elizabeth.

  The letters don’t attack, blame, or shame her. Instead, they express how hard it’s been for those who love her to see how much pain she’s in. They tell Elizabeth how much they worry about her and describe how her drug use has affected them.

  Elizabeth sobs—everyone does. After more than an hour, when Dr. Grissom asks if she wants to get help and treat her illness, she nods.

  Dr. Grissom drives her to an inpatient program, where she spends ninety days in intensive addiction treatment.

  That was six years ago. She’s been sober ever since.

  GETTING WELL

  Yes, addiction is serious and potentially life-threatening. There is good news, though—hopeful news: There was a time when people thought that sufferers of addiction were sentenced to a life of drug use and its consequences, which included failed relationships, illness, criminality, and an inability to get through school or keep a job, and that they would probably die early. We now know otherwise: as Dr. Nora Volkow, director of the National Institute on Drug Abuse, says, “We know that addiction is a disease that affects both brain and behavior. It is treatable.” That is worth repeating: addiction is treatable.

  People who suffer from this disease can have long, productive lives full of close relationships, success, and satisfaction, free from the pain that plagued them and the disease that controlled them.

  Treating addiction is complicated, because it’s a complicated disease. It’s not only serious; it’s also baffling in a way other illnesses aren’t. Other than a few mental illnesses, it’s the only disease that can cause people to think they aren’t ill. It’s not the fault of the person who’s addicted if they argue that they aren’t addicted, if they say (and believe) they’re fine, they can stop whenever they want. The addicted brain doesn’t think clearly or rationally because it’s malfunctioning. Addiction can cause people to feel grandiose—as if they know more than others around them—and paranoid—as if others are trying to harm or control them.

  Another confusing aspect of addiction is that if someone you love gets sick with almost any other disease, they probably want to get better right away. They go to the doctor to figure out what’s wrong and get treated.

  With addiction, however, though some sufferers go willingly (and some desperately) into treatment, some have difficulty accepting that they need help. Minors can usually be forced into treatment by their parents or guardians, but it can still be a challenge that’s often as traumatic for family as for the addict. That’s why families sometimes rely on interventions that include family and friends along with special intervention counselors.

  Sadly, people have a television image of drug interventions in which kids who need treatment are woken up in the middle of the night, handcuffed, and taken by force, thrown into a car, and driven to rehab. These kinds of interventions are dangerous and traumatic. Therapists like Dr. Grissom practice gentler and more effective ways to get someone into treatment even if they don’t want to go.

  One way, called CRAFT (community reinforcement and family training), guides families through the process. CRAFT also can help families help one another through a chaotic, scary time. You can find information about CRAFT in the back of this book.

  The challenge doesn’t end when a person is willing to get help. It’s sometimes difficult to decide what kind of help is needed and then finding it.

  Going into drug treatment can be scary, even to those in dire need of help (sometimes especially to those in dire need of help). Getting off drugs can be terrifying, both because of the physical effects of withdrawing from drugs and the psychological effects on people who’ve become dependent on them. Many people have told us they can’t imagine living life without drugs—they make excuses, deny they have a problem, refuse treatment—anything so they won’t have to stop using.

  In spite of their fears, people go into treatment for many reasons. Some choose to go because they recognize that they need help. They may be scared, but they’re more scared by their drug use. Many kids are forced int
o treatment by their parents, and some are forced into treatment by judges or courts.

  Some people will tell you that a person has to want to go into treatment for it to work, but that’s not true. Research has shown that no matter what motivates a person, all who enter treatment have an equal chance of getting better.

  REHAB

  There are different forms of treatment, including counseling and outpatient and residential programs. The first is for people who are at the beginning stages of drug use. They work closely with a therapist once or more often a week. The therapist uses a variety of counseling techniques. Depending on the kinds of drugs involved, some of those with substance-use disorders are given special addiction medications. For example, opioid addicts often respond to medications that lessen cravings and prevent overdose.

  As the names suggest, in outpatient treatment, patients attend a program part of the day, but they live at home or in a sober-living house. They also usually go to school or work. At first they may attend the program for four or five days a week, but if things go well, they’ll probably go down to fewer sessions—possibly three, then two, and finally one day a week, until they’ve completed treatment. The treatment itself usually consists of various kinds of group and individual therapy, education about addiction and dealing with difficult emotions like anger and sadness, and learning life skills. People in outpatient programs should also see addiction psychiatrists, who can help determine whether they need “dual diagnosis” treatment because they have psychiatric disorders like depression or anxiety as well as an SUD. Psychiatric and addiction medications may be used, and most programs include drug testing.