Rev Jon McCoy had the courage to allocate two Sunday services to a discussion of the opioid epidemic. I was invited to speak, and for the talk, I created a very short story. You can read it below or watch the video.
David kissed his wife on the cheek as he got out of bed. He hadn’t slept much. He’d spent most of the night pushing his arms into his stomach because he felt like it was the only way to contain the pain. He showered, got dressed, said a prayer, and entered his car as the sun was rising. For the next hour, he had one goal: get to the airport, pick up his brother and nephew and get back without breaking down. David’s twenty-four-year-old son, Adam, had passed away two days earlier.
He started the car, and the radio came on, tuned to a news station discussing the 2016 election campaigns. He turned off the radio and began the drive out of the upper income neighborhood in which he and his family lived.
David arrived at the airport and spotted his guests. His brother, Mark, was in his late forties, a few years younger than David. Mark lived in Portugal with his wife and two children. Mark’s eight-year-old son had travelled with hm to come to the funeral.
“Be strong. Don’t break,” David said to himself before getting out of the car. He and Mark hugged.
“I am so sorry,” said Mark.
David covered his mouth with his hand and nodded. He bent down, hugged his nephew and said with a forced strong voice, “How are you, Tomas?”
“I’m good, Uncle David. Is Adam really dead?”
Tomas’s English was good since his parents were raising their kids in both Portuguese and English. David knew that Tomas was a bright and inquisitive child. This would probably be the first of many questions.
“Uncle David may not be up to answering questions,” said Mark.
“No that’s alright, but let’s get in the car and we’ll talk during the drive.”
David thought that answering questions might be a good way to look strong in front of Tomas. He started driving and looked through the rear-view mirror at his nephew in the back seat. “Yes, I’m afraid Adam passed away, Tomas.” David whispered to Mark in the passenger seat, “How much have you told him?”
“Very little,” Mark whispered back.
“How did he die?” asked Tomas.
“Adam got a disease.”
“What’s the disease called?”
“It’s called Opioid Use Disorder.”
“What is it … Like, what does it do to you?”
“It makes your brain not work properly.”
David wasn’t surprised that Tomas wouldn’t settle for such a simplistic explanation. David responded, “Every person has opioid receptors in their brain. Normally these receptors are filled with natural chemicals called endorphins. That’s how people feel good or normal. For some people, use of opioids like painkillers or heroin increases the number of receptors. The person then can’t fill the increased number on their own and therefore feels pain and sadness. The person requires more opioids to feel normal. Taking more further increases the number of receptors, making the problem worse.”
“I get it,” said Thomas.
David added, “That’s an addiction. It makes your brain think that getting and using the opioid drug is more important than anything else in the world.”
“More important than living?”
“Sometimes, yes.” David gripped the steering wheel tightly.
“How did Adam get the disease?”
“He got it by doing things that many young people do. In high school, most of his classmates tried alcohol and marijuana. Some of them tried painkillers. All these things are drugs. Adam tried these with his friends. He got addicted, but most of his friends did not.”
“His friends are lucky,” said Tomas.
“You’re right about that.”
“Why didn’t his friends get addicted?”
“No-one really knows why it happens to some people but not to others.”
“If you have this disease, can you go to the hospital and get better.”
David whispered again to Mark, “My answers are bitter, given the circumstances. Do you want me to continue?”
“It’s okay. I’ll tell you if I think you should stop.”
David glanced at Tomas again through the mirror. “Hospitals don’t really help with this disease. Our country tries to get people to stop having the disease by putting them in jail.”
“I thought jail was for bad people.”
“Jail is for people who get caught doing something that’s against the law. Here, having this disease is against the law. Some people with this disease also commit other crimes to get money to buy the drugs they need. They go to jail for that also.”
“Is there medicine to help people with this disease?”
“Yes, but it’s difficult to get. Only a few doctors can prescribe it. Adam had the medicine but had to stop taking it when he went to jail.”
“Do lots of people get this disease?”
David decided he had given the child enough reality. “Not really, and nobody your age gets it,” he said.
“That’s good. I wish Adam didn’t get it.”
“Me t –.” David was not able to finish his sentence.
“Let uncle David focus on his driving,” said Mark.
Tomas turned his attention to looking out the window, then after a minute or so, fell asleep.
“You okay?” asked Mark.
“Yes, I’m okay. You know, his last question has a terrible answer. More than two million people are addicted to opioids and other drugs in this country. 170 die from overdoses every day. 70,000 died last year.”
“That is bad,” said Mark.
“Within a few of blocks of my home, four young people died from opioids in the last two years. There are probably more, but these were kids we knew. Kids who played with our kids growing up.”
“My god. It really is an epidemic.”
They continued the drive and spent a few minutes generally catching up.
David swallowed, then said, “You know, Adam had the disease for three years, and worked hard on his recovery, but most of that time, I told him to just stop.”
“You did what you thought was best. And I know you and Sharon set him up in multiple rehabs and programs, got him the medicine, and even moved him away a few times.”
David continued, “Also. I only recently started calling it a disease, myself. The American Medical Association defined substance abuse as a disease back in 1956. I had a son with the condition and didn’t consider it a disease until recently.”
“You were learning, man.”
“The night he died …” David’s voice began to shake. He took a moment to push the tremors back down, then continued. “… I suspected he was going to relapse. And I knew that relapsing would be dangerous for him. He had just gotten out of jail, so he had no tolerance. And he was no longer on his medicine. The jail wouldn’t let him have his Suboxone while he was there, so he came out completely unprotected. Despite all that, I went to bed because I had an important meeting in the morning. There was a threat to my son’s life, and I went to bed. What kind of a father does that?”
“David, fathers are not all powerful. You couldn’t watch him 24/7.”
“I don’t know. Maybe.”
“I didn’t realize the degree of his addiction,” said Mark.
“I know. I didn’t talk about it much,” said David.
His brother nodded and said, “Guys do tend to keep things inside. And this disease is certainly stigmatized.
They drove in silence for a few seconds, then David said, “Knowing what I know now, I would advise any parent whose child has this disease to do, or not do, whatever they’ll be able to live with if the child dies. If I could do it over, I’d focus on three things in this order: keep him alive; try to get him better; minimize the harm.”
They were in now in David’s home town. David glanced out the window and saw a father and son walking. An ache gnawed through his stomach like a knife. He gripped the steering wheel hard with one hand and pushed into his stomach with the other. He paused, then said, “Living with an addict was horrible. There were many bad times. Living without him is going to be a lot worse.”
They pulled into the driveway. Mark shook his head and said, “This is such a gorgeous community. I’m still shocked that four people within a few blocks of here died from overdose recently.”
David didn’t respond because Tomas was waking up. He turned around to look at his nephew, forced a smile and said, “We’re here.”