by Poorna Bell
I have plenty of friends and family who don’t see tobacco addiction or alcoholism as being as bad as heroin or cocaine use, but the fact is, all drug addiction is the same.
Alcohol and tobacco are more costly to the NHS than all of the class A drugs combined; tobacco kills the most.3 But somehow, cigarettes and booze are okay because they are socially acceptable. And they are socially acceptable because they are legal, despite being more lethal than the drugs we have been taught to fear since we were kids.
While I knew there were alcoholics in my family, I didn’t really know of any drug addicts. Many of us view alcoholism as ‘not great’ but tend to tolerate it. In fact, I’ve seen people give well-known alcoholics drinks at parties. Would you hand a coke addict a line of cocaine? Of course not, but the two are the same.
The drug report calls our view of addiction ‘simplistic’ and that it certainly is.
Before I found out about Rob, I viewed all addicts in the same way: broken and weak. I saw only in black and white. How could it not be weakness? Why couldn’t they control themselves? Because when you look at what addicts become – and, really, there are only ever three outcomes: recovery, prison or death – why would anyone choose that for themselves?
One of the things people have most difficulty in understanding about addiction is why the person can’t just stop – and this was also the reason I couldn’t really talk to my friends and family about Rob.
Dr William Shanahan, medical director and consultant psychiatrist at the Nightingale hospital in London, who has had thirty years’ experience in dealing with addiction, told me that when it came to opiates, it didn’t matter about the environment the person grew up in. It wasn’t about a weakness in character. That sometimes, regardless of their family background or the amount of money they earned, they used drugs for a number of reasons, one of them being self-medicating depression and anxiety.
His words reminded me of something Prof. Williams said about the premise of addiction being part medication. ‘The rest of us don’t see what’s going on and don’t even want to understand what’s in the mind of somebody who feels completely stuck to a pattern of behaviour.’
Opiates in particular are used to numb feeling or to fill an emptiness caused by something else, and considering his history with depression it should have been severely worrying to me that Rob had been struggling with drug use for twenty-five years. More so that it had taken over two decades for him to actually realise he was an addict, and was no longer – if ever he had been – someone doing drugs recreationally.
In society, addiction is more of a taboo than depression, yet the two share similarities: judgement from other people; misinformation around what it is; and they both originate in the brain.
Mix the two of them together, and no wonder there is little to no understanding in society about people who self-medicate a mental illness with drugs or alcohol. Who on earth would feel comfortable talking about their problem with friends over tea?
And perhaps the stigma that drives this need for concealment is the hardest aspect of addiction.
I could handle shutting myself behind a glass door and talking in a whisper so that my parents wouldn’t hear my English accent. That was of my choosing.
But when you are the loved one who deals with an addict? None of it, the lies and duality, is your choice, but the burden is almost as heavy and exacting as it is for the addict.
In Rotorua, on my trip with Prue and David, I see things resembling the painting of a dream. At Waimangu, streams of steaming water at the hot springs; algae, orange like a bright sunrise shot through with clouds of emerald greens; a lake of startling blue rimmed in white silica; tiny pipes of fumaroles blowing puffs of steam as if the earth was enjoying an after-dinner cigarette.
Walking around the bush that surrounds the valley, Prue takes a picture of me against a wall of tree ferns, captured in a wave of mist rolling across bubbling lakes. I look as if I could disappear, slip through a tear in the world to another dimension.
We’re here because I have never seen volcanic hot springs. The reek of sulphur permeates the town, and, before we left Auckland, everyone said: ‘Oh, you get used to it after a while.’
As fascinating as the hot springs are (and no, you don’t get used to the smell), the place I love most is the redwood forest, Whakarewarewa. I’ve always been fascinated by redwoods but have never seen them up close.
These ones are a long way from home, imported from California in the 1900s as part of an early trial, and are among the few trees, along with English oak, Douglas fir and Japanese larch, to survive the planting spree.
The main section of them is in a memorial grove which takes about thirty minutes to walk around, and there is an extra thirty-minute walk if you want to spend more time among the ferns sprinkled at the foot of the trees, their delicate little leaves starkly contrasted against the soaring height and silence of the redwoods. When we enter the grove, the air becomes heavy; everything slows down. The trees demand it. They have spent far more time than us on earth, and they will continue to do so when we are in the ground.
These huge, wooden pillars stretching up to the heavens, their branches streaming against the sky like hair caught in a breeze, push our perspective beyond our current point of pain, beyond our grief that at times feels like this is all there will ever be.
Everything feels primordial here, prehistoric, the scent of earth in my nostrils, and a stillness in my body save for a long, slow thump of the forest’s heartbeat, which reminds me of the first time I listened to my heart after it was fixed, the most beautiful sound I had ever heard.
But I also feel something else. As the worlds between old and new shift, the memories that the three of us are creating in the absence of Rob, I feel caught between the rate of time that passes in the world as we know it, and the rate of time as these trees know it.
I don’t believe in an afterlife, but I feel Rob so strongly in this place. I feel as if the answer to him is somewhere here, one hand on my heart, and one hand reaching towards the unknowable, wherever he has slipped through to.
It is a feeling so powerful, the grief that I cannot go to where he has gone almost brings me to my knees. I ask Prue and David if they mind me walking the rest of the track alone, and they nod with concern and kindness.
When I can no longer see them, I start crying. Through my tears I see ferns as far as the eye can see. I know from the brochure that these could be silver ferns, palm leaf ferns, black ferns.
And nothing will replace Rob, who would have taken pictures of them, been able to tell us exactly which was which, and explain their Latin name, their Maori name, where they normally grow and, in doing so, make our understanding of the world a little bit more beautiful, and a little bit wider.
Chapter Seven
For six months every Saturday morning after Rob told me about his addiction, I drove to a tiny building with blue glass windows in Forest Hill.
I’d kiss Rob and wish him a good time at his NA meeting, which started at 11am in Brixton. When he went to NA, he was often the only person in the room who still had a partner and one of the few who still had a job. Anyone who had a partner most likely met them after recovery; their previous relationships had not survived the rollercoaster of addiction.
I’d put on comfortable clothes, and carry something I could twist in my hands or hold close for comfort. Then I’d leave my home at 9.30am after a cup of tea, and I’d think about the two hours that lay ahead.
To stop myself going mad with the double life that had been pressed upon me without my permission, I realised I needed to talk to someone about what was going on.
When you’re in a marriage with an addict, at some point you will have to deal with their lying on a regular basis. But it’s not just their lies; it turns you into a liar too. It is a bitter pill, and swallow it you must.
Mal thought I was at the gym, my parents that I was busy cleaning the house. Priya knew the truth but had no way to gui
de me through this situation.
After desperate phone calls to my local council, I found that there was no support for the loved ones who look after addicts. We’re the ones who keep them fed, endlessly support them and defend their honour when everyone else doubts they are worth anything at all, yet no help was forthcoming.
When I made an appointment with Lambeth council to talk about this travesty, they invited me to their headquarters in Vauxhall and told me that, due to budget cuts, they had no funding to keep a support group going. ‘But you’re welcome to start your own,’ they suggested.
Great, because I had oodles of time what with working, maintaining my own sanity, lying to my family and friends, and keeping my husband in recovery. Considering how much is spent on drug addiction (including alcohol) in the UK – £15.4 billion – you’d think maybe someone would have the sense to support people like me who actually did still have jobs and were trying to help with recovery. I had to find out the hard way about the cost and reality of supporting a spouse with addiction issues.
Many phone calls later, I eventually managed to find a support group in a different borough, run by Donna, a woman whose kindness, empathy and firmness got me through the first six months.
On my first day, I felt like tracing paper. Ashamed and lost, see-through, with no language to describe how I was feeling. The daily conflicts, the yearning for our old life, my sadness for Rob and for myself.
In between going to NA and visiting his doctors, I saw how desperately he clung to redemption, and how tightly I held him so that he wouldn’t disappear down a crack. We tried to resurrect our life day by day, dinners spent in front of the TV watching zombie films, walks with Daisy. But we knew something huge had shifted.
Rob thought I didn’t notice but I knew how carefully he watched me from the corner of his eyes, wondering and waiting to see if I would leave. In disbelief that he had told me everything and I hadn’t left yet.
And I’m sure, at this point in the story, you’re thinking: How on earth could you forgive him? How could you carry on as if nothing happened?
And my answer is: Has the person you love most in the world ever said they were going to kill themselves, and, aside from the many other reasons contributing to that state of mind, one was because they didn’t want you to know who they truly were?
And if you had a chance to give that person redemption, so that they never felt so desperate as to try to gas themselves to death, are you telling me you wouldn’t take it?
Whatever punishment I could dole out, whatever judgements I laid at Rob’s feet, they would never, ever come close to what he was putting himself through. And even at that point, without all the knowledge I have now gained about addicts, drug use, suicide and mental health, I was able to understand that much.
There is such a stigma around addiction that addicts and the loved ones in their lives can rarely talk to anyone else about it.
My first support group meeting took place in a sunlit room. We sat on chairs in a circle after making tea and grabbing a croissant to eat in our laps. This was called the ‘check-in’, where you gave your name and a brief description of why you were there.
Newcomers, as in other support groups, were always given priority. I could see the circle move slowly towards me. Mothers of alcoholics, husbands of crack cocaine addicts, wives of crystal meth users. My face grew hot.
I don’t want to do this. I shouldn’t have to be here.
But if I didn’t share, the time would be wasted. And I’d have to wait another seven days before I could talk to someone else about it. So I pulled up my words that lay sunk, like stones at the bottom of a lake.
‘My husband told me last week that he was a heroin addict. He was an addict before we got married, he kept it from me. I don’t know how I am going to forgive him, but I want to. I’m so ashamed. I can’t tell my family. I love him so much but I don’t know how to get through this.’
I couldn’t stop crying. It felt like I would never stop crying, that it was coming from a tap jammed open, and it wouldn’t cease until I ran dry. Then someone handed me a tissue, and when the snot and the tears cleared, I saw the looks on their faces. It was concern but not patronising. It was ‘you’re here and that’s half the battle but we’re not going to fool you – this won’t be easy’.
But, above all, it was understanding. We were all in this room because someone we loved was an addict. And although understanding was not something we met with often outside of that room, we were there because we knew our loved ones were not terrible people; they were worth saving. They were still the people we fell in love with, the child who once had so much joy and promise, the sibling we had pillow fights with.
I learned so much about empathy and kindness in that room. But there was no denying what I saw also scared me. From what I read on drug forums, addiction was formidable. Dr Shanahan described the urge as being so strong he knew of people who had clambered over the dead bodies of people who’d overdosed to get the drugs left behind.
Some of the people in my support group had been with their partners for years. I saw how much it had defined their life – that constant swing between recovery and relapse. The fear in their eyes – the anxious people it had turned them into.
I wanted to know if anyone had succeeded in making it work; if anyone’s relationship had managed to survive. And all I found online were accounts of people dragged along the road of addiction with their partners, like their sleeves were caught in the window of a car and they were powerless to stop.
Perhaps this is testament to how much faith I had in Rob. Perhaps it is a sign of my own naivety or arrogance. But during the whole time I helped Rob through his recovery, especially in that first year, I was sure, so sure, we would be the exception to the rule.
Here’s the thing I don’t get about addiction: how, considering how widespread it is, we have managed to cock up treating it and being informed as to what it actually is.
The UK is described as the ‘addiction capital of Europe’4 and, although heroin use among the young has fallen, in the US there is something close to an epidemic. It has increased 63 per cent over the last eleven years. The number of women who use it has doubled, and there has been an increase in every demographic.5
It is telling that both countries employ a draconian approach to controlled drugs and addiction – a sentiment echoed by Dr Shanahan – and it is all too easy to draw parallels between their drug policies and ongoing failures to properly tackle a growing drug dependency crisis.
The general consensus is that drug addiction is bad, and people who are drug addicts are bad, and when someone who is a drug addict commits a crime, it is almost always framed in terms of their addiction.
Comprehending the nature of addiction is the first problem for a lot of people. Most of us have trouble understanding why someone doesn’t simply stop.
‘It’s the craving and urge to use, following the loss of the substance,’ said Dr Shanahan. ‘It’s not just an urge for chocolate or coffee. You can begin to understand it if you even look at smokers who cannot wait to get to their first, second or third cigarette. The average smoker takes seven attempts to give up cigarettes and we’re looking at a legal substance.
‘So the power of that feeling is magnified about twenty or thirty times with opiates. And therefore, if you take that from somebody, the loss to the body, the brain, the psyche, is unbearable. There is such an emptiness. They get sick as their body is withdrawing.
‘And even if you show them the damage they are causing and get them into a nice [facility], that urge remains in place. So what you really need is a patient with time and interest, and a well-supported detox. But first you’ve got to make a proper diagnosis – what is going on with the person? Are they full of shame and guilt?
‘That needs to be figured out before you go anywhere near “you’re a naughty person, you must stop using, we don’t like it”.’
Most people’s assumption about becoming an addict is t
hat it takes either a single hit or using a drug several times, one or other of those two scenarios. But the truth is much more complex than that, and until we start having honest conversations about it at every level, it will be very difficult to reduce the number of users.
The journalist Johann Hari, who saw his career derailed by allegations of plagiarism in 2011, subsequently spent three years of his life understanding addiction and the war on drugs and has some insightful views on the subject.6 He explains that while chemical ‘hooks’ are undoubtedly part of what keeps the person using the drug, it is not necessarily the whole story. He cites patients who go in for surgery and end up on morphine, but then do not go on to become morphine addicts once they leave.
After Rob told me about his addiction, he started to open up and talked honestly about his pattern of using. I always thought the emphasis was on withdrawal but, actually, the much bigger battle came after the drug was out of his system. The problem, he said, wasn’t withdrawing, it was staying clean. It was all of those chickens come home to roost – the realisation of what he had done, the lies, the shame.
In a letter he wrote to his doctor asking for prescription drugs to get him through another relapse, he wrote:
What I’ve got myself into is a rolling, absolutely rubbish addiction, where – from the first incident, where a combination of self-isolation, arrogance, the worst bout of depression I’ve ever experienced occurred – I do a minimal amount of gear, breeze through the next 48–72 hours, until in fact I’m over the worst of the physical withdrawal.
However, it is at this point (and this is like clockwork) that the first, and probably worst, bout of clucking occurs, and while I intellectually and practically know why I need to get through to the other side without using, I become such a wreck, so quickly, and am overcome by hopelessness and all the other tricks my addiction can throw at me, that I use a tiny bit to get me through what feels like an eternity of misery every second. And so the pattern repeats itself.