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Love, Drugs, and Rehabilitation

Opinion | February 8, 2016

As the second-youngest of five children, I grew up idolizing my eldest brother, Evan. Nineteen years my senior, Evan straddled the line between brother and cool uncle. I waited all year for him to come home at Christmas break, for weeks filled with adventures to musty bookstores, listening to bands I’d never heard of, and binging on candy my mom wouldn’t let me eat. Evan is the most brilliant person I’ve ever met. He’s also a recovering heroin addict.

When Evan first entered rehab nearly two years ago, my family and I attended a clinic for the loved ones of addicts. “Unlike other life-threatening illnesses, addiction will lie to you,” I remember the counselor saying. “It will steal from you, cheat you, and hurt you. Addiction is a disease that feels personal.” This is the best description I’ve found so far to explain the complex and often painful relationship between addicts and their loved ones.

At first, I believed that Evan would stop using just because I wanted him to. Growing up, he was always there when I needed him: picking me up when I fell, defending me in family arguments, and offering to beat up my bullies. I couldn’t understand then why he refused to do the one thing I actually needed: get clean. Like so many others, I saw Evan’s addiction as a choice, instead of as an illness. This could not be further than the truth.

According to The National Institute on Drug Abuse, addiction lives in the same part of the brain that governs our most primal needs, such as eating, drinking, and breathing. Addicts physically feel that they have to continue using to be happy, or even normal. Prolonged abuse can also result in changes in judgment, decision-making, learning, memory, and behavior control. For Evan, this meant continuing to use even as his life fell apart, even as he lost his prestigious job, house, and long-term girlfriend. He had to reach rock bottom before he finally agreed to get treatment. Although it took me a while, I realized that if Evan had the ability and choice to get well on his own, he would have. Heroin had taken that choice from him.

Unfortunately, very few people see it this way. Instead, the stigma attached to drug abuse is so strong that many see addiction as more of a moral failing than a legitimate disease. This misconception is fueled by the trope of the “druggie” seen in TV and movies. When people think of addicts, they see CSI villains, complete with sallow skin, shifty eyes, and deviant behavior. This stereotype fuels the argument that addicts don’t deserve help, resulting in a lack of compassion for both them and their families.

One woman I met in a support group summed up the contradiction perfectly: “If my child had cancer,” she explained, “people would be showing up at my door with casseroles. No one is cooking for me.” When I tell people about Evan, I get similar reactions, ranging from pity at best to judgment at worst. Worse yet, this stigmatization actually does little to deter addicts, instead encouraging them to be secretive about their usage and avoid help. But perhaps the most devastating effect is that it encourages punitive penalties for drug cases, instead of rehabilitation.

My home state, Maine, is a perfect example of this problem. Like many other rural states, heroin overdoses have increased significantly over recent years, jumping from seven in 2010 to fifty-seven in 2015. To deal with this problem, our governor, Paul LePage, has hired more drug enforcement agents and prosecutors, rejected Medicaid funds that would have extended coverage for substance abuse services across the state, and made national headlines for blaming the epidemic on out-of-state dealers who—according to LePage—“impregnate a young, white girl before they leave.” On top of being overtly racist, LePage’s policies are ineffective, poorly informed, and dangerous.

Experts agree that taking a “hard-line” on drugs does little to deter drug abuse. Instead, intensive care is needed to reverse the damage caused by narcotics. Inpatient treatment centers, like the one Evan attended, are proven to be the most effective recovery method. Patients stay beyond the initial 10-day detox period for an additional month of intensive therapy to address the root behaviors of addiction. Most professionals believe that even this is not enough; new estimates suggest that it takes the brain at least a year to heal. For a shot at recovery, addicts need regular, long-term care.

None of this comes cheap. My parents had to use their retirement funds to pay for Evan’s treatment, which I believe saved his life. However, many are not so lucky and simply do not have the necessary means. By directing funds towards punishment instead of rehabilitation, LePage threatens the lives of thousands in need.

Unfortunately, LePage is not alone in his way of thinking. Democratic presidential candidate Hillary Clinton told the Brennan Center for Justice in 2015 that she would deal with the drug problem by “put[tting] more officers on our streets, with a great emphasis on community policing.” Similarly, as the governor of Florida in the early 2000s, Republican Jeb Bush cut the budgets of drug treatment and alternative drug court programs, even as his own daughter was treated for usage of crack cocaine. Clearly, the pernicious assumptions of the “war on drugs” are still alive and well.

Luckily, the conversation surrounding addiction is slowly changing. The 2015 National Drug Strategy released by the Obama Administration lists education, treatment, and prevention as priorities. Although these lofty ambitions have yet to turn into legislation, they do indicate a change in attitude. This is also reflected by a new drug bill in Maine that the state legislature passed unanimously—even the governor can’t overturn it. The bill provides funding to a new detoxification center in the eastern region of the state, which will provide at least 10 beds to those that can’t afford care on their own. But, this is only the beginning.

I seriously debated whether or not to use my brother’s story in this piece. Apart from it being a painful part of my history, I never want to turn his struggle into mere emotional currency. But ultimately I’ve decided to share, hoping to give a human face to addiction—both on the Tufts campus and in general. The only way to defeat the stigma around drug abuse is to open up the conversation. As long as society sees addicts as villains, there can be no hope for improvement.

So I’d like you to meet my brother Evan. He likes classical music, Korean food, and Star Wars, maybe a bit too much. He is complex, often annoying, and always on my side. He’s almost two years clean. He’s my big brother.