On Pills and Needles

by Rick Van Warner

  While I understood these concepts, I tried a different approach this time. Instead of my prior “follow our rules or get out” stance, I adopted a more compassionate, nurturing approach at the suggestion of my therapist. Overpowered by my emotional guilt and childhood scars, I had neared the edge of an emotional breakdown. More than ever before, I drank and ate to calm my mind and mute my secret pain. I simply couldn’t shake the nagging guilt over having spent more time with Tommy’s sports-minded brothers than him, feeling that I’d emotionally abandoned him much like my father had abandoned me. Whether it was Boy Scout campouts or crew meets, I’d missed out on Tommy’s activities in lieu of coaching my other sons’ teams or following my own musical passions. My inflated pride in my youngest son’s various athletic accomplishments didn’t help, and I’m certain it must have hurt Tommy to hear me regularly boasting about his little brother.

  I was drawn at this time to a restaurant industry leader who was smart, kind, and confident in his faith in Christ. Kim carried himself in a completely different way than the holier-than-thou, arrogant believers that had pushed me away from my faith. He was humble and let his actions speak for his beliefs. I know now that God put Kim in my life to help me discover my purpose, but at first, I just enjoyed being around one of the smartest and kindest people I’ve ever met. We met for weekly breakfasts to share personal struggles, completed the Man in the Mirror book together, and have remained close despite not seeing each other as often. More than anyone else, Kim helped to restore my faith through this brokenhearted and guilt-ridden time.

  Meanwhile, I tried to reconnect with my son in a more gentle way. Clearly he was fragile, both mentally and physically. With love, I attempted to get him to open up so I could better understand the root of his insecurities and unhappiness. I learned almost nothing.

  “What’s going on, son?” I asked.

  “Nothing, I’m fine,” he said.

  “Do you want to talk about what happened?”

  “Not really.”

  “Did anything ever happen to you that I don’t know about that you want to share? I swear, I will keep it between us.”

  “Dad, nothing happened!”

  “I love you, son, I just want to understand so I can be in a better place to help you.”

  “I’m good.”

  Meanwhile, Mary and I continued to disagree on nearly everything, sniping at each other verbally and with disdain. The issue continued to divide us and hung like a dark cloud over every aspect of our lives. As my youngest son Barry pointed out, “Don’t you see? The only time you guys fight it’s all about Tommy.”

  We still went to sleep every night in dread, waiting for the phone call we were sure would come. When either of us came home from work, Tommy’s presence on the couch or cooking pasta in the kitchen with his latest girlfriend would sour our moods almost immediately. With our eldest son studying overseas and his car sitting idle, we stupidly began allowing Tommy to drive again, likely a subconscious move to find some relief from his constant presence.

  Things soon began to spiral downward, as his by-now-familiar descent into Oxy addiction resumed. His teeth began to turn a nasty greyish color as his personal hygiene deteriorated. We noticed him scratching his scalp or his arms a lot, sure signs of pill abuse. His sweet disposition again disappeared, replaced by snarly, terse replies to our questions or the vacant, dispassionate stares we loathed.

  Tommy pulled into the driveway one night with the passenger window of the car shattered, pieces of glass all over the seat. His girlfriend’s brother had punched it out in a rage during a fight with his sister, supposedly. Within days, Tommy got in an accident, and we yanked his driving privileges permanently but not before contending with the threat of a lawsuit and another spike in our insurance rates.

  For a short time Tommy began seeing a new therapist, a streetwise, no-nonsense young woman who completely saw through his lying and BS. It seemed to be going well and there was another brief calm before the storm. Mary had been taking him, and the therapist wanted both of us to come with Tommy to one session. We were fairly certain he’d gone back to using pills based on his demeanor and hygiene, but he’d been insistent that he was only smoking pot. After a brief time alone with Tommy, the therapist summoned us to join them.

  “Tommy’s been telling me he’s doing better, and that while he’s not completely clean, he has stopped using Oxys,” she said. “What are your thoughts?”

  Mary and I looked at each other skeptically, and then glanced at Tommy. He stared at us intently to see what we’d say. After a long pause, Mary started.

  “I don’t know, I’m not sure I buy it,” she said. “What do you think, Rick?”

  “I don’t know either; we’ve already been burned so many times that I can’t tell the truth from lying anymore.”

  “Go ahead and drug test me,” Tommy said, shaking his head in disgust. “You guys never believe me. I don’t know why I even try.”

  “Why don’t we believe you?” I asked in the slim hope we might find meaningful discussion that could lead to a breakthrough.

  “Because of the past. You don’t trust me.”

  “How do you get trust?” I asked. “Trust is earned, not given.”

  “By staying clean. Go ahead and test me so we don’t have to keep having this annoying conversation.”

  “Tommy,” the therapist said, “your parents are just trying to understand what’s going on. Tell them what you told me.”

  “This is a huge waste of time,” he said. “If you’re not going to trust me, then test me.”

  We called his bluff. Mary left and bought a comprehensive screening kit from a nearby Walgreens and returned to the office. I supervised his filling of the urine cup to ensure he couldn’t cheat, and then while he met with the therapist in private, waited for the results. Not surprisingly, the panel testing for the Oxy family of pills, long his drug of choice, tested positive, as did THC for marijuana. Confronted with the results, he now claimed that he’d taken pills just once a few days earlier, but wasn’t taking them regularly. More lies.

  As I drove Tommy home in silence, I felt my disgust and anger building. I’d worked very hard to try to open the lines of communication between us and make him feel accepted back into our family. His betrayal and constant lying made me realize I’d been suckered once again.

  When we got home there was a FedEx package leaning against the front door. It was his Christmas present, an expensive ticket to a multiday concert festival taking place two weeks later that he would no longer be allowed to attend. He recognized it immediately, grabbed the package, and opened it.

  It had long been determined that any money received from selling that ticket would become reimbursement for the hundreds of dollars in items he’d stolen from us. When I reminded him of this, Tommy convinced me to let him take the ticket because he had a friend who was going to buy it from him. Again fooled by his masterful manipulation, I complied. In the spirit of my new approach, despite the lies just experienced at his doctor’s visit, I sought to give him opportunities to regain trust and reluctantly agreed to let him go sell the ticket himself. I made him promise to get me the cash and even said he could keep twenty dollars for food and spending money.

  “You’re a fool,” Mary said derisively when I told her I’d given him the ticket. “We’ll never see that money.”

  Not only was she correct, we also didn’t see Tommy again for nearly three days. Cash in hand, Tommy did what addicts do. He went on a binge and spent all of it on drugs.

  Once again our lives were engulfed in madness. Incensed that I’d been deceived and that once again he had stolen from us, I reverted back to the futility of trying to play detective. As I quietly worked my way through a dark lakeside park on a windy night looking for him, it hit me how ridiculous my actions were. But I was so upset and angry it felt better than doing nothing. Finding no clues in the park, I returned to my car and drove throughout the area, scouring familiar haunts and coming up
empty. It was a fruitless effort to find a needle in a haystack. By now Mary and I weren’t speaking to one another. Dejected, I headed to a sports bar to grab a bite and a couple of pints before heading home to the silence of her glares. She wasn’t the only one disgusted with me. I’d become disgusted with myself.

  The following day while at work, I received a frantic call from Mary just before lunchtime. On a hunch she’d gone to a garage apartment where a friend of Tommy’s lived, and sure enough he was there, along with a 6ʹ7″ massive friend who had recently been released from jail. A screaming session ensued and ended with Tommy telling his mother how much he hated her and slamming the door in her face.

  I completely snapped for the first time in months and left my office to race toward the house where Mary had found the pair. By now they were long gone of course, but that didn’t prevent me from pounding on the door and shouting for them like a madman, baseball bat at my side in case the young giant decided to try to stop me.

  Driving up and down nearby streets, I checked the 7-Eleven, the park they liked to hang out in, and other areas for what seemed like an eternity. Then in the distance I spotted a very tall man walking next to a very slight man, and recognized the color of Tommy’s bright yellow soccer shirt. What a pair they made, a Mutt and Jeff linked only by a love of the drugs they shared and not any type of meaningful friendship. When I jumped out of my car near them the hollowness of their relationship was quickly revealed, as his “friend” immediately crossed the street and started briskly walking away as if he didn’t even know Tommy.

  “Where’s my money?” I demanded, baseball bat still at my side for the misguided reasoning that the larger friend might be a threat. In reality, I was the one more likely to get arrested by wielding a bat in a quiet neighborhood at midday.

  “I don’t have it, it’s gone,” Tommy shouted. “Leave me alone, go away.”

  I walked back to my car and drove away, not expecting to see Tommy for a very long time, if ever again. My rage turned to tears and I sobbed uncontrollably as I tried to refocus on going back to work. How many times by now have I found myself in this horrible state of grief? I wondered at the time. How much more can we possibly take?

  One night a few days after the street confrontation, Mary and I were in the kitchen when we were startled by a knock on our kitchen window. It was Tommy.

  “Can I come in?” he asked. “I want to talk to you.”

  Apprehensively we let him in. Among the recently discovered missing belongings were my chainsaw and an expensive Bose speaker designed to play iPods, clear signs that Tommy had fully relapsed, as if we needed more proof.

  “I’ve got a problem, and I need help,” he said. “I’ve got to get out of Orlando.”

  As it had many times previously, false hope washed over both of us, and we immediately sprung into crisis mode. We began searching the internet and working phones with people we’d met through the support group to find the right program. This time, we thought, we’ll find the perfect program to help get Tommy sober.

  6

  Out of Sight, Out of Mind

  Sitting in a circle of folding chairs in the center of the room, we listened as stranger after stranger recounted familiar tales of pain, anger, and despair. From California to Maine, blue-collar towns to wealthy suburbs, the story was the same—drug-abusing children nearly destroying families and marriages.

  The campus where Tommy now lived was more like a barracks than we’d imagined, a two-story brick building with the equivalent of an exercise yard on one side. Although no razor wire–topped fence surrounded the place, it quickly became clear that residents didn’t see very much of the Utah sky or the mountains in the distance. From Tommy’s room the focal point was a nearby Taco Bell sign, reminding him of food he couldn’t taste and freedoms that he’d lost.

  Tommy’s residential treatment center in southern Utah, one of many throughout the United States, cost us more than $6,000 per month. Diving tens of thousands of dollars further into debt was not something we wanted to do, but we felt it was our only choice. We often used the unfair analogy that if we had a kid with cancer, we’d spend everything we had to save him. We were hardly alone in our thinking.

  Thousands of parents like us, from all types of different backgrounds and situations, plunge into enormous debt or pour their life savings into recovery programs that rarely yield successful outcomes. It is a thriving industry that preys on desperation and guilt.

  This is not to suggest that there aren’t some excellent programs and dedicated doctors, therapists, and counselors working in the recovery field; there certainly are. In some cases, such as my younger brother’s, years of sobriety were achieved after just a few weeks in such a center. But to consider this route the only solution to a relatively unsolvable problem is like saying the only way to avoid an auto accident is to attend driving school.

  Over the course of nine years that to date have involved at least thirteen relapses, detoxifications, and recovery attempts, we’ve concluded that many treatment programs are simply money pits. For some families, it’s a way to kick the can down the road by paying enormous sums to try to solve their family member’s problem. For others, it is similar to the purpose reform schools once served, allowing parents to maintain their busy lifestyles without the burden or embarrassment of a troubled child in residence. In the end, recovery and residential treatment centers, like any other business, exist to make money.

  A 2015 documentary, The Business of Recovery, questions the effectiveness of expensive residential and outpatient programs,1 an estimated $35 billion industry and growing.2 Today there are more than 14,500 specialized drug treatment facilities in the United States.3 Most are unregulated with marginal success rates, if any success rates are even tracked.

  Our family made significant contributions to this business, incurring far more than six figures in debt tied to trying to save Tommy as he shuffled between various voluntary and involuntary treatment facilities during his late teens and early twenties. There seemed to be three common denominators. First, regardless of how dire the situation or how sick the potential patient, no one may enter through the gates until the facility is absolutely certain it will get paid. Second, anyone who enters will immediately meet brothers and sisters sharing an affinity for the same substances that landed them there, often creating alliances to depart and begin using again. Lastly, rarely do they work, resulting in massive amounts of money spent for an extended vacation from a problem that resumes once the money runs out, and often sooner.

  Some may argue that we are just bitter over having spent so much money on a son who doesn’t or won’t ever get it. Others may conclude that we never found the right program. In our experience, recovery programs were mostly overpriced places focused first and foremost on raking in as much money as possible from desperate families and their insurance providers. These programs are the first to preach about how only an individual committed to change has a chance to get clean, yet they will gladly admit anyone forced to be there by court or family, provided they can pay. It’s big business, plain and simple.

  With substance abusers cycling through them like foraging ants in and out of their hill, it is virtually impossible to find meaningful statistics regarding success rates from treatment centers or twelve-step programs. Yet that doesn’t stop “experts” from throwing numbers around.

  The Sober Truth: Debunking the Bad Science Behind 12-Step Programs and the Rehab Industry, written by a psychiatrist who has spent over two decades studying and treating addiction, pegs the success rate of AA-based twelve-step programs at 5–10 percent.4 A seasoned counselor and Narcotics Anonymous (NA) veteran I once discussed the subject with agreed with this assessment but pegged the recovery rate for opioid addicts, defined by him as staying off drugs for at least one year, at less than 5 percent.

  Chasing real recovery success stats is akin to playing the carnival game Whac-A-Mole, minus a stuffed animal prize—the target is always moving and the misse
s are many. For starters, only about 11 percent of the estimated 23.5 million people age twelve or over with a drug or alcohol problem ever seek treatment, according to Substance Abuse and Mental Health Services Administration research.5

  Meanwhile, those who do achieve success through treatment programs are rarely ever contacted again for follow-up, a friend who is a recovering addict recently reminded me. “It’s been seventeen years since I completed my first rehab program, and not once has anyone from there contacted me since,” he said, noting that neither his phone number nor address has changed.

  Although real stats are as elusive as the problem itself, most people agree that opioid addiction is one of the very toughest dependencies to break.

  For Tommy, landing in a Utah facility with other teen drug abusers was certainly not his choice.

  “I hate this place,” he told me. “They’re only in it for the money, they don’t really care. It’s like being in jail.”

  Tommy’s path since being hospitalized after we’d managed to find him in the decrepit naval barracks was very typical, we later learned. His first of thirteen detox and rehab attempts ended in less than a week, with his need to use drugs far greater than his will to stop. His initial rehab facility was located in the Florida Panhandle, and we decided that I would drive him up directly upon his release from the only hospital in our area with a mental health unit that included a drug detoxification program. There would be no chance to go home, no chance to run, no opportunity for either him or us to change our minds about what was to happen next.