Again, as almost daily, the operative word “family” appears in yesterday’s NY times story titled entitled
In Heroin Crisis, White Families Seek Gentler War on Drugs
The blatant truths that (1) the health insurance industry is behind the triage – profit margins are threatened by the severity of opioid crisis, (2) a retributive justice system offers some but very scant solutions, (3) heroin and fatal overdose are the endgames of disordered opioid use, and (4) family investment is the endgame to it all.
The healthcare system is in no position to offer hope or resolution of any consequence. Interdiction efforts are inadequate to deflect the supplies that clamoring American users line up and pay for day after day. Prescriber behavior that unleashes “innocent, non-junkie” use has been raked over the coals well enough.
Families have inestimable, hidden power. They have the opportunity to invest their OWN energies, time, priorities and limited funds to reset the course for those whose disordered use. My suggestion is to forget – to a great extent – what the health industry is going to do about it. Stop wasting time and money with an institution that is, after all, a business that must profit financially to show up as managers of healthcare.
The Family Disease concept has been swept aside by families now for decades. The addictions treatment establishment has offered, taught and prodded families that mostly don’t get it. The ones that do “get it” are far more likely to become agents of change with their drug-compromised loved one, be they son, daughter, sibling or spouse. This established perspective parallels the community reality.
Communities are vulnerable to and also compromised by the family disease phenomenon. Communities are next in line to best reduce harm and risk. Neighborhoods, in a word, are the communities that can educate and prevent loss and initiate care. Examples are everywhere, particularly in the most challenged states of Ohio, Kentucky and West Virginia.
Let’s go with the terminology of NYT’s article title: War. Communities of greater affluence are less in the fight. Stigma prevails there. Communities of lesser influence are more in the fight. They are out in the open, leading the way.
In clinical practice, as a long-term recovering heroin addict, I have offered families guidance in the form of therapeutic family coaching for years. Under a signed consent for THEIR treatment, if they elect that approach, I have been able to help them make the difference. THEY become the silver bullet.
But most families decline. Over the past four to five years into the opioid crisis, most families declined my offer of professional clinical assistance. Even without requirement of payment. They aren’t the problem. It’s the medical prescribers. The laws. The psychotherapeutic providers. The stigma. The self-help communities.
Until families become willing to suffer the inconvenience of family recovery, the potential for ongoing addiction and fatal overdose will remain prominent. In the headlines. Medical prescribers can improve in their care delivery, including the provision of authentic integrated care, and medication assisted treatment (MAT) versus treatment assisted medication.
The legal system can improve by balancing between retributive justice and restorative justice. The psychotherapeutic treatment community can improve by demanding family engagement. Or declining the much preferred “please repair our damaged member – we’re okay” requests for incomplete intervention.
The media – both public and private – can continue its de-stigmatization efforts. The self-help communities can improve in their heroic efforts by taking care of themselves and living the new truths they have found by personal investment in health and wellness.
Why wait? None of these entities have the combined power and will to effect immediate change. Get informed, get reorganized and get moving. Families and communities feel the dangers and losses first. Until they take action, business and government will be deciding whether to act. Or how to act.
David Petersen is a clinical interventionist, in practice in the southwestern U.S. Information is available at DavidPetersen.org.