Note – This is a true story based on my own experiences and what I’ve heard from the people involved, but for privacy, all of the names have been changed.
Note 2 – This is an old piece, republishing was accidental.
I grew up in a “hamlet” (the administrative level below “town”) in the Northeastern US, with a population of just over 3,000. It’s not so much a community as a bunch of scattered homes in the middle of the woods barely connected by two one-lane highways and a network of mostly dirt roads. The closest thing to a “center” it has is a church, middle/elementary school, deli, and gas station on one stretch of road. I attended that school from kindergarten through 8th grade, and graduated from it 13 years ago from a class of 30 students.
So far, 2 of those 30 have died from heroin overdoses, along with one other student from two grades below me, and a dozen individuals from the adjacent school district within the same age range. All were male.
One of those two from my graduating class was Jack, my childhood best friend. He died at age 23.
His death was entirely unexpected to me, but seemingly everyone else in his life knew he had been addicted to heroin for five years. During and after the wake, funeral, and mourning period, I did my best to figure out what happened to him. From a broad sociological standpoint, Jack is a case study in how a white, middle-class teenager with good parents growing up in a fairly affluent place somehow ends up dying from a drug addiction. From a personal standpoint, I just wanted to know how this happened without me knowing about it.
The following is my attempt at putting everything together. I’m going to do my best to not just write another “sad addiction story.” I want to try to find useful take-aways from the experience that have some sort of relevance for how we do/should look at addiction, mental illness, and treatment.
Jack was dealt a bad hand in life, though you wouldn’t know it by looking at him. He was 6’1, 200+ pounds, and built like a linebacker at his peak, though his weight seemed to careen up or down within a 40-pound range, likely due to where he was in his addiction cycle. Growing up with him, I was vaguely aware of the host of mental and physical issues which plagued him, but I didn’t realize how bad they were until much later.
Throughout elementary and middle school, Jack missed more days of school than anyone else I knew, and one year he came close to failing to graduate because of it. The reasons he gave for absences were always vague – some sort of fever or headaches. Even now, the true causes are not clear because his many issues were always tangled together.
The root cause may have been a severe social phobia. Apparently he felt intense anxiety whenever he was around anyone outside a select few family members or friends. I knew that he didn’t like to go out, especially in high school and the later years, but from our ordinary interactions I had no idea it was a serious issue. Around me he was funny, sometimes witty, and would never not want to play video games or watch movies, and just as importantly, talk about them afterward. But when I wasn’t around, he was apparently terrified of being disliked and shunned by acquaintances and strangers alike.
Then there were the migraines. Even after he died, I never got a straight answer as to the cause or truth of this problem. All I know is that he often complained about getting debilitating migraines that forced him to stay in the quiet dark of his room, sometimes for days straight. Jack’s parents took him to doctors and specialists trying to get to the bottom of it, he tried numerous treatments and medicines, but I don’t think the cause was ever identified.
I’m not entirely sure the migraines even existed. On a few occasions, Jack admitted to me that he faked being sick to get out of school. It’s plausible that Jack made them up to get out of school or socializing, and his well-meaning but enabling parents let him do it.
Jack’s only real hobbies have forever been video games and tennis. He spent much of his days playing games in his room, either with me or a few other friends. When he was younger, he played tennis at the local country club where his father was the undisputed club champion for many years.
One time when Jack was in middle school, he walked off the tennis court after a well-played match, and his mother asked him how he felt. Jack said something like, “when I’m out there, it’s so nice… it’s like the rest of the world goes away and I don’t have any problems.”
Jack’s mother never forgot that. She thought it was a strange thing for a 13-year old to say. It was too heavy and somber. A kid his age is supposed to love sports for the visceral thrill of movement or victory, not because it drowns out the rest of his life.
It was the type of thing that Jack’s brother, Derrick, would never say. Derrick was two years younger, and the opposite of Jack in almost every way. He’s shorter but naturally athletic, and even when he was young, everyone knew he had charisma. He’s naturally the life of the party, always surrounded by friends, almost supernaturally romantically successful (he dated a senior during his freshman year of high school), and though he leans towards attention-seeking, that can usually be ignored because of his overwhelmingly good nature.
Probably as a result of their polar-opposite personalities, Jack and Derrick never got along. They could play video games together when I was there, but fighting was common, and occasionally turned physical. In retrospect, this was a precursor for what was to come. Even in grade school, Jack was pulling family resources away from Derrick – their parent’s time, energy, and money went where it was needed most. And that wasn’t Derrick.
In tenth grade, Jack broke his ankle or leg (I forget which). For the surgery and months of being cast-bound ahead, he was given a prescription painkiller (I think Percocet, but I’m not sure).
A few months after his injury, Jack’s father remembers a conversation where he asked Jack how the painkillers felt. Jack said it “made him feel normal.”
My understanding of events at this point is a bit hazy because I wasn’t around as much. Though we continued to live in the same small town I went to a different high school than Jack and eventually Derrick. I still saw Jack occasionally, usually to play video games, but weirdly I started getting closer to Derrick. I was still almost completely in the dark about Jack’s issues, but I started to see signs that something was wrong. Despite knowing each other for almost our entire lives, our conversations were always impersonal. I remember him being moody and dour for obfuscated reasons. My mother recalls me once referring to him around this time as a “nihilist” (that was probably the year I read Fight Club).
Jack’s few other friends from our middle school must have also drifted away, because he found new friends. The wrong ones.
The town next to the one where Jack and I grew up is slightly larger. It has a picturesque main street leading down a steep hill to a gazebo on a drop-dead gorgeous riverfront. On weekends, it’s packed with tourists coming in from the nearest major city to climb local mountains, kayak, or shop in antique stores. And now its younger population is teeming with heroin addicts.
That’s because this town is undoubtedly a wonderful place to retire or visit, but it’s not the best place to make a life. There are no jobs, no industry, no innovation, nothing but a tiny community purposefully locked in an idyllic aesthetic for the sake of its tourist dollars. Of course, that’s not the worst thing in the world. It’s safe, and pretty, and great if you like hiking. But anyone who grows up there or nearby needs to get out after high school… or else they rot.
My hamlet wasn’t large enough to have its own high school, so most students went to the neighboring town in 9th grade. This is where Jack fell in with the wrong sorts of people. The more ambitious and affluent young people among the two towns went to college elsewhere, or moved to the nearby city, or worked and saved for a few years to go elsewhere. But other kids know from day-one that they have no future. Their fates lay in a boring, frozen small town where apparently there’s nothing to do but hike and take drugs.
These were Jack’s new friends.
I vaguely knew most of the people in this cluster, but not enough to give detailed psych breakdowns. What I do know is that they weren’t the products of broken homes in Rust Belt post-industrial hellscapes. Like Jack, all of these kids were at least middle class, and some quite wealthy. Some of these kids were dumb. Others definitely weren’t. Two years before Jack died, we lost another student from our graduating eighth grade class to a heroin OD. Though he was always a troublemaker, he was undoubtedly one of the smartest kids in the grade. Likewise, a student two years younger than us who ODed a few months later was also said to be quite intelligent. However, I can’t speak to the capabilities of the dozen other OD cases from the neighboring town within the same cohort. At the very least, most of these individuals graduated from high school, and I think a few made it to local colleges, though plenty of others dropped out.
Like Jack, all of these kids seemed to fall into a malaise. Whatever spark drove other kids in similar backgrounds and places to make something of their lives – to get college degrees, build careers, make relationships, etc. – it didn’t happen with them. Consciously or otherwise, they seemed to accept that their lives began, would continue, and would possibly end within a small cluster of picturesque towns where nothing ever happened. They would never grow as people or accomplish anything, so they just wanted to feel good.
Jack’s trajectory in high school was fairly typical given his future. He got injured, was given a painkiller prescription, but eventually he ran out, so he tried to get more, and he hung out with exactly the people who knew how to do that. At some point in his senior year of high school, Jack upgraded to heroin. His grades tanked, he had more health problems than ever, he barely showed up to class enough to pass, and he took on a ragged, worn-out appearance.
Valuables started disappearing from Jack’s home. Jack’s mom lost jewelry. Jack’s dad was often missing money from his wallet.
Jack’s parents noticed their son’s weird behavior problems, but couldn’t identify the cause, and didn’t connect him to the missing valuables. Jack had always been sickly and moody, so they figured it was more of the same, but worse because of the stress of high school. They figured it was probably his social anxiety causing him to hole up alone in his room every day after school. Besides, their attention was being pulled towards Derrick. He took to partying as soon as he could, and had more than a few close calls with alcohol poisoning. (I was hanging out with Jack one night when Derrick, then a freshman, stumbled home so drunk that we had to wake up his parents because we thought he might die.) Derrick did alright in school and had plenty of friends, but he tread dangerously close to his own troubled territory.
Jack and Derrick’s relationship deteriorated as their personalities continued to pull away from each other. Shouting matches became a common occurrence. Insults became personal. The household order was breaking down. Again, the parents just thought it was sibling squabbles. Those were expected. They could be managed, but never entirely stifled.
But there was more to it. Derrick went to Jack’s high school. He heard rumors. He knew who Jack’s friends were.
During one of their explosive fights at home, Derrick charged at Jack, grabbed his arm, pulled up his heavy sweatshirt and long-sleeve shirt, and saw track marks.
Jack broke down and begged Derrick not to say anything. Derrick ran downstairs and told his parents.
You’re a middle-class parent in a middle-class life and you just found out that your son is doing possibly the worst thing a kid can do to himself. What do you do?
These things happen. There are procedures. There are people and places who specialize in these things. You find them through Google and you use them.
Maybe a Slate Star Codex/Less Wrong reader would start diving into the efficacy rates of different treatment options and crawl through peer-review studies and use Bayesian reasoning to predict your son’s odds of returning to a normal life over X number of years… but that’s not the typical parent. The typical parent is terrified, clueless, and desperate. So the typical parent does what everyone else does.
In this case, that means rehab. I forget exactly how many times Jack went, but I think it’s in the 4-6 stint range over a five-year period. Each instance was between one and three months, and cost $20-40 thousand.
After every rehab stint, Jack would come home clean. As torturous as overcoming heroin withdrawal may be, it’s not complicated. You lock the addict in a room, keep an eye on him, provide food, water, and medical care, and wait. Unless he’s extraordinarily crafty or the rehab facility is extraordinarily shitty, the addict will eventually get over the hump. Then he’ll have counselling for a few weeks or months, stories will be told, strategies discussed, and then he’ll go home.
Then the parents need a plan.
Plan 1 – Lockdown
Heroin destroyed Jack’s life, so his parents figured they needed to stop him from getting heroin. Even if Jack wanted to get clean and rebuild, there are always moments of weakness. There are bad days, the migraines, the depression, and worst of all, the friends. The parents knew they needed to keep an eye on Jack and make sure he didn’t succumb to temptation or weakness.
That meant Jack couldn’t be alone. Ever. If he was home alone, his old friends could stop by with a drug delivery. If he went out by himself, he could go to his old friends and get drugs. Our town is rural, so it’s not like Jack could walk anywhere interesting from his house, but he certainly couldn’t be allowed to use a car on his own. Of course, this meant Jack couldn’t get a job, run errands, hang out with friends, go to the movies, play tennis, go to Gamestop… unless one or both of his parents accompanied him. Also, no cellphones, and strictly limited and monitored internet access, since Jack could use these channels to contact his old friends. And just in case, it was best not let him have any money.
This meant that everyone in the family had to completely reorient their lives around Jack. The father worked full time as a salesman, and often long hours, but the mother was a housewife, so most of the burden fell on her. Almost every second of every day became based on keeping track of Jack. If he needed to go out somewhere, she would drive him there, stay with him or watch him from afar, and then drive him back. But Jack rarely needed or wanted to go anywhere after school ended, so both he and his mother basically entered a state of house arrest. Both would typically spend days straight at home, with the mother taking periodic breaks on the weekend or late at night when the father was around.
The Lockdown wasn’t air-tight. Jack contacted his friends while at rehab and made a system for covertly exchanging money for drugs, even while trapped at home. His parents made him walk the family dog in their backyard. It was a large clearing in the middle of their wooded neighborhood, separated from the road only by a plastic chain-link fence. One of Jack’s friends – usually the smart one from our class who would OD before Jack – would bike by the house, find Jack’s money taped to the fence, and leave the drugs. Jack would get them while walking the dog, hide them, bring them back to his room, and use at night when his parents were asleep. I’m not sure if he somehow hid the track marks (maybe by injecting between his toes?) or went back to snorting.
Jack and his parents battled over the lockdown for years. Sometimes they were able to keep an eye on him, cut off all access to his friends, and even bust their smuggling operations, and sometimes they weren’t. As Jack repeatedly relapsed and went through so many expensive rounds of rehab, reality dawned on them…
Even if the lockdown worked, then what? Then Jack was a young man who barely passed high school, living at home with his parents, with no job, no prospects, no friends, no romantic/sexual life, no status, and absolutely nothing to look forward to. No wonder he was doing drugs.
The parents needed a new plan.
Plan 2 – New Start
Jack needed a life. He needed goals, self-esteem, responsibility, stability, and happiness.
The fundamental problem was that none of these things could just be given to Jack. He could be helped and supported, but he also needed to reach out and take these opportunities. But taking these opportunities meant giving Jack the most dangerous thing of all – independence.
If Jack got a job, he would need a car to get there. If he had a car, he could drive to the places he wasn’t supposed to go, talk the people he wasn’t supposed to talk to, and get what he wasn’t supposed to have. No amount of monitoring timeframes, gas usage, or anything else would stop Jack from getting drugs if he really wanted to while going to or from work. Same thing with developing any sort of friendship or relationship outside the confines of immediate family.
I didn’t see Jack too often during the stronger Lockdown periods. I was living half-way across the country while going to college, but every once in a while, I’d visit him over the summer. After I returned from college and lazed about my hometown for two years, I saw him more, and I think this is when he entered the New Start period.
I still knew nothing. I didn’t know about the drugs, the rehab, or any of it. But I did recognize that Jack was going nowhere in life. I assumed he would at least go to a community college, but that never panned out, and he didn’t seem to have a job, so I wondered what the hell his plans were beyond sitting at home playing video games.
I started asking Jack what he was up to when I saw him. And I distinctly remember getting different answers every few months. He was going to go to community college, then he was going to be an electrician, then he was training as a computer repairman, and I forget two or three other new ventures. These plans were often accompanied by conspicuous gifts he received from his parents – a massive new tv for his room, a brand new gaming computer, funding for a trip to Colorado to see friends he had met through online gaming (who also turned out to be addicts), etc.
The plans never lasted. Given the impersonal nature of our hangouts (still very much based on playing and talking about video games or movies), I never questioned him. I assumed he was floundering, unsure of his future, and still trying to figure himself out.
In reality, Jack’s parents were bribing him. They would come to Jack with a plan to jump-start his life, usually based around some sort of education or job training, they would sweeten the deal by promising to buy Jack something fancy if he committed, and with more rewards to come. Jack would accept, get his rewards, but it never worked out. Jack never stuck with the programs and never stayed clean long enough. I honestly don’t know if he ever genuinely tried to fulfill any of his agreements.
I’m a libertarian who thinks all drugs should be legalized, including heroin. But I have to admit that learning what Jack’s addiction did to his family made me understand the “Drug Warrior” perspective better. Unless an addict has no social connections whatsoever, his addiction will hurt others. The stronger the connections, the worse the pain. If the supporting friends and family members hold on tightly enough, it will destroy them. Derrick described the five years of being with Jack through his addiction until his death as a “living hell.”
To start with, fighting addiction costs money. Jack’s family was solidly middle-class, with his father pulling in enough money alone for the mother not to work while affording a nice home, comfortable day-to-day life, and the occasional vacation. They were decently well-off, but not enough to sustain the hit of $150K+ of rehab costs.
I noticed some of the effects from afar but didn’t get the full picture until after Jack died. First the family stopped going on vacations, then the mom got part-time work (which wasn’t easy while trying to keep Jack in Lockdown), then the father worked longer hours, and eventually they were draining their retirement funds and mortgaging their house.
But monetary costs were nothing compared to the emotional toll. How happy can you really be on a day-to-day basis when you come home to where your heroin-addicted son or brother lives?
Jack’s parents basically lost their lives. Every single day, every single minute, was oriented around Jack. They always had to know where he was, what he was doing, when his next Narcotics Anonymous meeting was, if they could afford that therapist, etc. The father no longer worked to build college and retirement funds, but to pay off debts. The mother didn’t stay home to take care of the house and kids, but to keep her son alive.
Then there was the lying.
The social stigma of drug addiction, especially heroin addiction, is scarcely better than the ordeal itself. Granted, this is in the process of changing. Heroin addiction has moved out of the inner cities and into suburbia, and the shift in the class (and possibly race) of the average addict seems to have created sympathy to counteract the stigma.
But still, there are plenty of people who consider heroin addicts to be the lowest of the low. Degenerates. Weak-willed. Wastes of life. More at home in the gutter under a bridge than in polite society. What would happen to Jack if his high school principal found out? Would he want to keep a heroin addict at the school? Next to other students? Would the PTA? How would acquaintances, friends, and anybody else look at Jack if they knew?
What would I do if I found out?
In retrospect, I was probably the closest person to Jack who didn’t know. Though we drifted apart, Jack and I still spent time together and I considered him a friend. But more of a “hanging around to bullshit” friend, like someone to play video games with on a boring afternoon. I had no idea that I was so much more to him and his family.
I was the last beacon of normalcy in Jack’s life. Though the family did their best to cover the addiction, rumors spread, and Jack withdrew from the remnants of his sparse non-toxic social life. By the time I came back from college, I was his only friend who didn’t know. I was the childhood friend who could come over and make him feel like he was back in eighth grade for a bit, when things weren’t so bad. We often literally did the same things as back in eighth grade – sat in the same room (his bedroom), played the same video games, and ate the same pizza or burgers delivered by his mom.
I was not in a good time in my life. I graduated from a good college with a bad degree and I had no clue what I wanted to do. I was burning what should have been my early career years sitting in my childhood home, playing video games, and working a menial service job. But to Jack’s parents I was a model of stability they prayed their son would follow. The dad loved to talk politics with me, the mom loved to cook for me, and they would try to get me over the house as much as possible to give Jack a bit of relief. It was only with me that Jack was allowed to use the car without his parent’s supervision. They knew he would never get drugs when I was there. He wouldn’t shatter the illusion he and his family crafted for me. It wouldn’t be worth it, not even for a fix.
I don’t blame the parents for lying to me. I don’t know what I would have done if I found out the truth. Besides, they have enough guilt to grapple with.
Jack’s parents raised a kid who ended up going down basically the worst possible pathway imaginable. If Jack had grown up into a serial killer, that would have been terrible, but at least psycho-murderers are beyond reason. There’s something almost inhuman about them. They can’t be figured out. But drug addiction is just an extreme coping mechanism for ordinary problems – depression, anxiety, misery. So how could the parents let this happen? What had they done wrong? How had they mistreated Jack? What life skills did they not impress? What did these ordinary middle-class parents do to raise their oldest son into a heroin addict?
Jack’s parents will never entirely get over these questions.
Then there was Derrick. Just when Jack’s life tanked, Derrick pulled his together. It turns out that the binge drinking and casual drug use really were just a phase. His grades improved, he fell in love with neuroscience and nutrition, he overperformed on the SATs and got into a much better college than his parents expected. A private college.
Derrick transferred away from his private college to a state school at the end of his first year. By this point, I considered Derrick to be a much closer friend than Jack, and we regularly spent time together. I asked him why he transferred schools. He was evasive. I only later learned that Jack’s latest round of rehab had emptied Derrick’s college fund.
For years before then, Derrick’s life had inexorably been consumed by Jack. The instant Derrick showed his parents Jack’s track marks, his childhood ended. Jack became a black hole at the center of the family which sucked everything in. Money, energy, time, and attention only flowed one way. Derrick stopped being another son and was repurposed as an asset to be employed by his parents for Jack’s sake.
The family needs groceries. Dad is at work. Mom needs to stay home to watch after Jack. She can’t take Jack with her to the grocery store because he has one of his migraines, which may or may not be a lie he’s using to cover up his latest drug use. So Derrick has to get the groceries. Derrick has plans with friends? Sorry, the family needs him to do this.
That may seem minor, but the little requests built up. They ate at more and more of Derrick’s life right when he needed his freedom. At the end of high school, Derrick was figuring out how to put his considerable talent to use. He spent more and more time working out, which naturally paired with his fascination with nutrition. Plans started to take shape – study neuroscience in college, become a sports nutritionist, etc.
But Derrick couldn’t spend every hour of the day at high school, the gym, with friends, etc. He occasionally had to come home. And that’s where Jack was. Sitting in his room in the dark down the hall pulling the family down right as Derrick was rising to better places. Derrick doesn’t blame his parents for how they treated him (neither do I), at least not consciously. But he still felt resentment. Towards Jack and his parents. He felt it every day living with a presence which only produced burdens, which forced Derrick out of childhood into a quasi-caretaker role, which permanently altered Derrick’s relationship with his parents for the worse.
Derrick had many reasons to resent Jack, but Jack had his own grievances. Derrick was a reflection of all of Jack’s failings – socially, emotionally, familiarly, academically, physically, even romantically. While Jack’s life slid into hell, his brother down the hall went to parties and hung out with girls and enjoyed life absent the burden of crushing inscrutable ailments that could only be alleviated by fucking heroin.
The fighting became worse than ever. They weren’t physical anymore, not while Jack deteriorated and Derrick bulked up. Yet they were more vicious than ever. More personal.
Derrick remembers one time, only a few months before Jack died, when at the end of a shouting match, Derrick yelled, “Is this what you want your life to be?”
It was a short question, but there was more than either of them could ever say aloud packed into it. This was Jack being twenty-three years old, sitting alone in his childhood bedroom with blackout curtains covering the windows, in a plush chair in front of a big screen tv, and knowing that his life would never get better than this. This was Jack sucking the family dry in terms of time, money, and energy, all while producing a thick cloud of misery over their lives for five years with no end in sight. This was Jack knowing that he was the lowest of the low, and was pulling the people who loved him down with him.
Jack responded to Derrick by simply saying, “no, it’s not.” But he had no follow up. Not even excuses.
The fight ended.
I’m going to get more speculative here. I never actually talked to Jack about this stuff, so my understanding of his mindset comes from inferences from our communication, and what his family told me after his death.
The puzzle of getting Jack permanently off drugs and onto his feet could never be solved because there was a missing piece – Jack wanting to get better.
Of course, in his most desperate moments, when confronted by his weeping parents or well-meaning rehab workers, Jack promised that he wanted to kick his habit. He promised that he wanted to make something of himself and build a life and be a normal person. Maybe he even meant it in those moments.
But in the long run, he didn’t.
First there were the experiments that showed how rats will continue to indulge in an addictive drug until they die, even starving themselves for the sake of getting another hit. There were the Rat Park experiments which showed that rats chose to have fun in awesome rat parks rather than continuously indulge in addictive drugs. Then there’s Scott Alexander’s Against Rat Park which argues that a biological predilection to addiction tracks long-term addiction rates better than environmental factors. That makes sense to me. Except that rats can’t think long-term. Humans can.
This is the part that seems like it flies in the face of basic, functional logic. Being a heroin addict is so incredibly obviously a horrible life choice that it’s difficult to grasp why someone would do it. Yes, I know it’s physically addictive, but that probably wasn’t the fundamental issue. The D.A.R.E. model of drugs being a mind-control vector doesn’t hold water anymore. Jack got clean many times, his family offered every conceivable means of support, he was literally bribed to just follow basic life guidelines, and yet he still consistently returned to the drugs.
For me, the scariest part of learning Jack’s full story was realizing that he may have been acting rationally. I’m not saying that being a heroin addict is rational, and I’m not saying that Jack made good choices, especially not given the emotional carnage left in his wake, but… I think I understand why he kept going back to the drugs.
In Trainspotting, the heroin-addicted protagonist has a classic monologue:
“People think it’s all about misery and desperation and death and all that shite, which is not to be ignored. But what they forget is the pleasure of it. Otherwise we wouldn’t do it. After all, we’re not fucking stupid. At least, we’re not that fucking stupid. Take the best orgasm you ever had, multiply it by a thousand and you’re still nowhere near it. When you’re on junk you have only one worry: scoring. When you’re off it you are suddenly obliged to worry about all sorts of other shite. Got no money: can’t get pissed. Got money: drinking too much. Can’t get a bird: no chance of a ride. Got a bird: too much hassle. You have to worry about bills, about food, about some football team that never fucking wins, about human relationships and all the things that really don’t matter when you’ve got a sincere and truthful junk habit.”
I’m guessing Jack had a similar thought process.
So much of life is hard. Whether you like it or not, you’re thrust into status competitions, hedonic treadmills, and endless hassles. So many people get up most days at early hours to do something they find tedious, annoying, and belittling for eight hours straight just so they can afford the basic amenities to keep themselves alive. They watch other people get rich, get lucky, be beautiful, be praised, all while smoldering in resentment at their own mediocrity.
I think everyone is aware of these shitty parts of life. But almost everyone is also aware of the good parts. Family, friends, and loved ones reflect our values and fuel our lives. Hobbies, passions, and maybe even work are outlets for our virtues that convert effort and inspiration into rewards. It’s not easy, but we all fight to make the good parts as big as possible while minimizing, mitigating, or maybe even ignoring the bad parts.
I don’t think Jack was ever aware of the good parts. And I think his bad parts were intrinsically worse than most people’s.
Let’s say Jack stuck to one of his parents’ New Start plans. After years of living under borderline-house arrest and going through the tedium of the lowest tiers of academic education or the physical strain of blue-collar training, Jack might emerge with enough qualifications to be an electrician or computer repairman.
Then Jack is a depressed, anxious, migraine-ridden, twenty-something living at home with his parents, with no friends, no romantic relationships, low wealth, no status, a haunting heroin addiction behind him, and worst of all, no future. His job as a computer repairman won’t really change anything.
For each of these detriments, Jack might have been able to turn things around. Maybe through therapy and medication he could have blunted the social phobia. Maybe he could have gained new friends. Maybe he could have worked his way up the electrician’s union ladder. Maybe.
But Jack had his social phobia since elementary school. He had tried plenty of medications and therapists and it hadn’t worked. What were the odds that Jack would finally turn it around when he was 23 and still living with his parents, and getting over a heroin addiction? If someone in his community college asked him what he had been up to the last few years, what could he say?
Jack wasn’t a genius, but he wasn’t dumb. He could be witty in conversation, and he had a real skill for tinkering. My mom often asked him to do little fixes around our house when he came over; the night before he died, he fixed the door to her bedroom. But Jack wasn’t conscientious. With the exception of video games, he never really dedicated his efforts to anything. He only got through school because his parents dragged him kicking-and-screaming and even his once-promising tennis skills had dried up during high school due to apathy.
And by the end, whatever natural talents Jack once possessed had long since been sapped away. Derrick told me that Jack mentally stopped aging at 18. Once he got into heroin, his vitality nose-dived and never returned. Whether it was the drugs, his depression, or both, a dullness set into him. Forget about studying for tests, Jack didn’t cook, or clean, or do his laundry. At an age when many kids go off to college and live alone for the first time, Jack was more dependent upon his parents for daily needs then he had been since before elementary school.
Jack believed he was never going to make friends. Or make it as an electrician. He lacked the confidence and discipline. And even if he focused all of his willpower and family support on one of his problems, there would still be a dozen more behind them. There was no solution to this nexus of problems. He was doomed. Or at least that’s what he probably thought.
To put it another way, Jack was painfully aware that his future options were, “be a complete loser,” or “be a complete loser who feels really really good for a few hours every day.” He chose the latter.
What if, for some people, there are no solutions?
For some, there is no treatment for their depression. There will never be a better career. There is no better life off drugs.
I think that’s plausible.
Your happiness is a balance between all the good and bad things in life. Some people are cursed with such strong innate bad factors that no amount of good will overcome them.
I don’t know for sure, and I would never ask them, but I think that’s what Jack’s parents eventually concluded.
Near the end, it seems like both the Lockdown and New Starts were abandoned. Jack did manage to get a job, but it was dog sitting for a family member. He was given use of the car to get to and from the family member’s house, and he was paid far too well for the job.
Again, I can’t say for sure this is what happened, but my sense is the parents accepted that Jack wasn’t going to turn things around. He wasn’t going to overcome his social phobia and start a career, let alone move out. Or stay clean. The new plan seemed to be based around providing comfort to Jack to limit his suffering. At least with his job, he had some sort of purpose, and wouldn’t have to steal money. I honestly don’t know if the parents accepted that his drug use couldn’t be stopped.
One day, when Jack was 23-years-old, his parents left the house together to see a movie. It was the first time they had gone out together without Jack in six months. Derrick was also out that night, working a service job with me over the summer to make some extra money. The parents came home with a cheeseburger for Jack, and they found him in his room, passed out in his own vomit on his bed. His mother called 911 while his father tried to resuscitate him, but Jack was already dead. His cause of death was an overdose, though it’s unclear whether he accidentally took too much or hit a bad batch.
After the wake and funeral and shock, Derrick admitted that he felt relief. It was finally over. His parents seemed to imply much the same. Their son had suffered for so long, but not anymore. They will never fully recover from losing their child, but at least they got their lives back again. They are doing their best to move on and find some sort of happiness in their later years. Derrick is more than self-sufficient on his own, and currently runs his own company.
I wish I had a happier note to end this on, but honestly, my biggest takeaway from the whole experience is that maybe some puzzles just can’t be solved. We can try to attribute Jack’s problems to intrinsic biological/psychological issues (social phobia, migraines, etc.) or to environmental causes (super high rate of heroin use and OD in the community), but both sides seem fundamentally lacking in explanatory power. The vast majority of socially anxious people don’t resort to heroin, and despite the problems of these small towns, they are by no means among the worst places to live in America, let alone the world.
Sometimes a perfect storm of fundamental errors, bad luck, and shitty incentives come together to ruin a person’s life, and there is no fix. That’s horrible, and tragic, but it’s probably just reality.
12 thoughts on “The New Epidemic – My Experience of Losing a Friend to Heroin”
Well said. Especially what you say about “ordinary problems”. There’s far too much concentration/exploitation about addiction’s “exceptional” causes, whereas mostly it’s the same tedious shit we’re all going through. Maybe if we could accept that at least in part it’s “reasonable” behaviour we could avoid some of the the criminal/deceitful/anti-social/destructive consequences.
I spent years working with junkies in London, and this is as close and as clear a description of how addiction pans out for all concerned as I’ve come across.
I see parallels between caring for a heroin addict and raising a mentally-disabled or -challenged child (MDCC). A neighboring family of mine has three children, one of which is a severely-autistic boy named John (name changed). He has never nor will ever produce any words, only grunts and hand gestures. I’m not sure his mental age, but it’s quite low. He will never be able to live on his own, leaving the burden to his parents (unless they opted for another caretaker or facility, but I don’t see that happening).
In my interactions with them, a large majority of their time and attention goes to John and away from their two other children. At the neighborhood pool they have to always keep an eye on him to make sure he doesn’t drown or drink the chlorinated water or do something else. They rarely go out to eat. Their relatives don’t enjoy their company because of John. And they will have to do this every waking hour of every day of every year until John dies (a cursory Google search says 16 years sooner than average). I’ve never asked the parents or siblings how they feel, but I can only imagine exhausted and maybe a few other harder emotions. They never asked for this, much like Jack’s mom never asked for her son to become a heroin addict and her life be (arguably) ruined. The siblings, while outwardly understanding and very kind towards their brother, may harbor resentment towards John due to his being a “black hole” of sorts; some attention still goes to the siblings, but not nearly the 1/3 per child a normal family would get.
But unlike caring for a heroin addict, they can’t simply give up. Jack’s parents could easily stop supporting him (easily as in legally, it would not be easy mentally/morally to kick your heroin-addicted, mentally-underdeveloped child out of the house to fend for himself, but I’m sure some parents do it). John’s parents can’t, at least until he’s 18, and then what would he do? He won’t be able to support himself in any fashion, and there seem to be no free homes for severely-autistic adults. It’s also societal-taboo to abandon a mentally-disabled child like John. How would they look to their friends and family, who can’t understand what the years of caretaking does to person? I imagine Jack’s parents would have experienced the same questions: “How could you just give up on him?” “He can get better, you just have to keep trying?” Well, autism isn’t curable and heroin addiction is one hell of a disease and arguably the strongest addiction out there. After all, how can you not want to pursue the best-orgasm-ever-times-one-thousand, especially when there’s not much else going on in your life?
So, where is the middle ground between your job and role as a parent to help and support and love your child through thick and thin, and wanting to live your own life that you originally thought would be dramatically different than what it became?
All this not to say that parents of MDCC can’t feel joy. I just imagine that the ratio of unhappy:happy parents of MDCC is greater than 1.
If you haven’t read it yet, check out the book Requiem for a Dream (it was a book before a movie). Excellent perspective on an addict’s mindset as they spiral deeper and deeper in addiction (heroin and amphetamines are the book’s examples).
Great post. I especially like “Sometimes a perfect storm of fundamental errors, bad luck, and shitty incentives come together to ruin a person’s life, and there is no fix. That’s horrible, and tragic, but it’s probably just reality.” Although, it’s not “probably just reality”, it IS reality.
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I know this is way out there, but it really isn’t, I promise and that there could have been a bio-psycho-social link here to tall the pains and headaches. There is new research that supports this. Check out “JAMA pain reprocessing therapy”. I know it is too late, but this is a massive epidemic and doctors can only prescribe so many opioids that don’t work. For more on this also search “Curable headache recovery story”. This is real stuff, and I only found it and its effectiveness after 20 years of chronic neck/back pain. I wish I had known about it sooner, because before that, I didn’t have much hope as so many practitioners acted like they knew but they didn’t know at all.
There is a new film out that helps take the shame out of the drug addiction cycle called “The Wisdom of Trauma” by Dr. Gabor Mate and it is so transformative that I recommend the entire world watch it. I held back my tears because of who I was around, so if you watch it, make sure you are in a place where you can cry and let those feelings be felt. It really puts addiction in a new light and is key to breaking our society out of the cycle. I think it will pair perfectly with the upcoming film “Pain Brain” (search Pain Brain Film) that discusses the Boulder CU study on Pain Reprocessing Therapy.
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Telling a story honestly is powerful stuff. Gripped… from beginning to end. Thank you.
Resonates with my impression, with a family member with similar prospects for different reasons.
I wonder how Jack would have fared as a Monk in a Monastery?
My friend’s daughter just died. Her mother said ‘but she was doing well’. I told her ‘she had an innate fragility that didn’t go away, even when she was doing well’. And so when (after a while of being clean) that guy offered her drugs, she took them. Even after being clean. Even after doing well. Because who she was didn’t go away.
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I think your friend was selfish. He wrecked his family. He knew what he was doing. He allowed a demon into his soul. It happens. But, in the end it was his choice. He took everybody down with him. No honor. No privilege. No obligation. No divine order.
Thanks for your interesting article.