Heroin

Overdose: A Mother's Perspective

International Overdose Awareness Day: A Mother’s Perspective

About 40 years ago, a nurse that I supervised was brought as an overdose to the Emergency Room where she worked. She was pretty and petite, and a sweet, kind person. It was a shock to me when she was brought in. I only knew her as a great nurse with a wonderful smile. In my tenure in hospitals, I have seen/taken care of several people who overdosed on drugs or alcohol. In those times, cocaine was the substance most often the culprit. When my son died of an accidental overdose 9 nears ago (it seems impossible that it was that long ago), I was devastated and embarrassed. No one in my family had ever overdosed, never mind been addicted to drugs, that I knew of. (Subsequently, people revealed situations that, to that point, locked behind a wall of shame and silence.) When I was told by the Medical Examiner that heroin was the main drug in Sean’s system, I was shocked. I knew that he had used various other substances, with alcohol his drug of choice; however, heroin was never on my radar screen. Sean was usually pretty open with me about his challenges and habits, but one never really knows.

In the two weeks surrounding his passing, 4 or 5 other young people also died from heroin, and only one of them was a known user. I had really no previous knowledge of heroin use, other than its portrayal in movies. I found it suspicious that so many had died, but could only surmise that the heroin was more potent than it should have been. I also knew that Sean was placed on a tranquilizer by the rehab he had been in, and that would have potentiated the effect of any other respiratory depressant. I’ve since learned that detox, itself, can make you more susceptible to an overdose, as your liver, now cleaned of toxins, cannot handle doses previously tolerated. That is something that I believe every person facing drug detox needs to know.I don’t know that I can explain the feeling of finding out that your child has died. For me, it was a very surreal experience. I had been so worried about him, that I was almost panicked with fear and concern, so I used a gift certificate I had gotten some months before and had a massage. As usual, I went into a kind of trance (often, sleep). All of a sudden, I thought, “Sean is dead.” I couldn’t stay a minute longer, and on the way home called a friend with my fear. As I walked into the house, cell in hand and her still on the phone, the house phone rang. That was the beginning of the biggest challenge and cause of self-reflection I’ve ever faced. Challenge because I had to figure out how to keep it together for Bridget and my granddaughter, in particular; and self-reflection, because it must have been my fault. Somehow, I should have done something different or better.

The story’s been told many times about how Sean and I tried to find the support and insight he needed for almost 2 decades, as well as the incompetency of the rehab he was in. I had found it, myself, after researching all that a place should offer for his situation (dual diagnosis). Their literature indicated that they were on the cutting edge; that they knew exactly what he needed. Obviously, they didn’t. That debacle is a whole different story.

As far as the OD itself, I’ve found out that Sean expressed that he just wanted to sleep. I take some solace in the fact that he had been suffering and in a panic for so long, that he at least passed in peace. It’s so very weird how you will hold onto anything to cope. At one point, a few days after his passing, I distinctly heard Sean’s voice, saying, “Mom, I didn’t mean to make everyone so sad.” I’ve never heard a voice before or since, but this voice was distinctly Sean’s. I knew that’s exactly how he would feel. He couldn’t stand if he made someone angry or sad. It was that part of his soul that could never hold a grudge, or deliberately hurt anyone but himself.

First, I was in shock, of course, and had a particularly hard time with the heroin. I really had no knowledge of a prior use by Sean (if he weren’t a user, there can be an intolerance making first-time users more apt to OD). For me, the name itself denoted something so much darker. Marijuana, cocaine, and alcohol were all substances with which I was familiar. Although I have no personal experience with illicit drugs, I know many people who have experimented with each of these. But, heroin, that was for drug addicts, concocting for me, visions of needles sticking from scarred, emaciated arms. (The ME confirmed that Sean did not use IV heroin, which I didn’t even know was an option. I did know he’d be hesitant to use a needle … he was a wimp when it came to pain and procedures!)

What enabled me to cope with all of this was the fact that Sean was known in Atlanta (not to mention internationally. His obituary was in several US papers, as well as the London Guardian). I’m told it was even on the evening news. Creative Loafing did a front page spread, and about a year ago, the Atlanta Journal Constitution did a cover story. The Guardian and US articles were really beautiful and kind. The Atlanta papers highlighted the salacious parts of Sean’s passing, missing an opportunity to describe him as the person he was, conveying that addicts are not their addiction. I’ve heard that there were some really despicable things said online. I had no interest in reading others’ prejudiced notions of a person they never met, certainly didn’t know. Nonetheless, in my little world, all of my family, friends, and neighbors knew the details of his passing, down to the motel he died in. I couldn’t escape the anticipation of malicious gossip.

Somewhat a loner, and to a large degree indifferent to others’ judgments, that part didn’t affect me as much as knowing that nothing that was reported reflected Sean (other than the London article and those of the Blues community). That broke my heart. He was very shy, and private about his life. He often told me not to tell stories about him at Northside, that ‘people liked to talk.’ I didn’t realize how intense the light on him was, and how quickly people could turn.

He never would have wanted people to know the circumstances of his passing, and, in fact, all they knew was the outcome. There was so much more that put him in jeopardy and eliminated his support (primarily me and his stepdad). He was alone, at the prescription of the rehab facility. He followed their demand to be independent in order to succeed in his sobriety. Failure would have been humiliating and depressing to him on many levels. As usual, he was keeping his anguish private. The world didn’t give him that honor in his passing. (Please note that leaving someone in crisis alone is the exact opposite of what should be done. Never, ever, leave a person alone if you sense that they are struggling.)

Glenn, Bridget, Allison and Lauren, as well as his Dad, Aunts, Uncles, and Grandmother struggled with their own anguish and disbelief, as did so many of his friends. The impact of such a death is so very different than one expected due to age or illness. It’s genuinely tragic, as horrendous to loved ones as a car accident. In fact, for him, and many others like him, it was an accident.

So, what do we do to prevent the tragic loss of others to substances? For me, it meant learning about why Sean became addicted to alcohol, his main drug of choice, along with misuse of other substances. I know that he longed for sobriety and ‘to be normal,’ because he told me those exact words. I also know that he worked hard to get there, and did for periods at a time. I also know that the world let him down. I’ve since put my energy into finding out how to diagnose and treat bipolar disorder, a precursor to many addictions. I felt as a mother would feel if she lost a child to cancer. We just didn’t know enough, nor have the tools to help. Unlike cancer, however, an addict cannot be cured. More like a chronic disease, it needs to be managed. We’re just not to the point where we know how to do that with predictable success. In my mind, research is key.

In the article I researched and wrote for the newsletter, I explain briefly about the impact that Fentanyl and its derivatives have had on use of heroin. The rise in the use of heroin is directly related to the increase in the availability and misuse of prescription drugs. Eventually, demand caused the price to skyrocket; thus, making the much cheaper heroin attractive. Drug dealers, in my opinion the epitome of evil, can make more money by substituting some of the heroin with a cheaper drug. That drug is increasingly becoming Fentanyl and its derivatives.The potency of Fentanyl and its chemical relative, Carfentanil, is the catalyst for the horrendous rise in overdose deaths in the US. (I refer you to the newsletter of November 29 for more information). Overdoses are now the leading cause of death for people under the age of 50, surpassing motor vehicle accidents and suicide for young people. Researchers believe that the vast majority of overdoses are accidental, and the introduction of Carfentanil has upped the ante for a fatal outcome.

Maybe this ‘epidemic’ shouldn’t come as such a surprise. Addictions have killed many throughout the ages, and ruined an exponential amount of lives. However, the numbers are too impactful to ignore. Yet, as a society, we’ve turned a blind eye to substance abuse. Heavy drinkers are just winding down, or being social… alcohol is legal, after all. Cocaine was the drug of choice for successful businessmen, and almost glorified in shows and movies. Meth is considered to be the drug of the poor, so virtually ignored mainstream. But heroin, that’s the ugly demon in the closet, saved for people we really don’t want to know.

Addiction, however, doesn’t have a face. There is no stereotype. Of course, some people wanted to lump Sean into the category they’ve concocted of all musicians and creative artists… sex, drugs, and rock and roll... like it’s deserved. But as his dear friend, Levon Helm said, that wasn’t who Sean was. I’m fairly certain that the baseball player from Georgia Tech who died about the same time as Sean, had less publicity, and hopefully, less scrutiny of him, his family and parents. Nonetheless, they were both victims of our ignorance regarding addiction.Because of Sean’s celebrity, I was very, very lucky. Friends and fans came from everywhere to pay their respects. The church was packed, and the cemetery was full of people who admired or loved him. I don’t know if other parents who lost children in the same way were quite as blessed. There is no one profile of an addict, or one who accidentally overdoses. Each person was an individual, loved, and significant to this earth.

Now that people are dying at extraordinary rates, maybe monies will be dedicated for research for prevention and treatment. People rallied around the HIV crisis, and research has led to incredible outcomes. HIV is no longer an inevitable death sentence. It’s time to recognize that suborning the stigma about addiction is depriving the world of potential inventors, artists, musicians, and healers, both medical and spiritual. Families are robbed of children, siblings, and grandchildren. We cannot afford to be so capricious about anyone’s life.

Sean was extraordinary as a person, a musician, and a son. I can guarantee you that every parent who has lost a child feels the same. We need your help to give our loss meaning, and to prevent yours.

I congratulate the persons responsible for International Overdose Awareness Day, and challenge each of us to be an instrument for change.

In loving memory of my only son,

Debbie Costello Smith