How do I help my friend the addict?
May 3, 2012 5:51 PM   Subscribe

How do I help my best friend who is using heroin? Back story inside.

My best friend, Lisa, became my friend in an odd way following the death of my ex and her ex. We instantly fell into a great friendship.

She has two teenage children and a boyfriend who is a junkie. He has served time in jail, repeatedly, and in fact was arrested today, in DC, for having heroin on his person. She is going down this path because of dealing with chronic pain.

She was using Dilaudid to help her pain, and her boyfriend introduced her to shooting it, instead of taking it orally. Of course, she needed higher and higher doses as time went on. Now, she is to the point that between the two of them 90 pills last about 3 days, if they are lucky, most often less than that.

Since Lisa is addicted to the Dilaudid now, of course when they run out she becomes sick. He had her try heroin to keep the sickness down between the availability of Dilaudid. Heroin is cheaper, she says, as the doses last longer and Dilaudid is very expensive on the street. She is now addicted to the heroin.

Having said this, he is now in jail, she is living in a home his family owns. His family is probably going to kick her out. Right now she is out of work (due to being laid off, not drug use) and on unemployment.

She has no vehicle as her's died, recently.

I have tried to convince her to go to the ER and ask for help, but, she's afraid they will call CPS and she'll lose the one child that lives with her.

Is this true? Will the ER automatically call CPS? What else can she do? She has no insurance, but are there other treatment options?

We are just outside the DC metro area, in Fredericksburg, VA, if that helps any. I don't know what to do, I don't want to lose my best friend, but, what can I do to help her?

Thanks in advance.
posted by anonymous to Human Relations (22 answers total) 1 user marked this as a favorite
 
Has she asks you to help her? You can't help her against her will. I know it is a terrible thing to watch someone you care about go down this path, but unless she is asking you for specific things she needs because she is ready to get clean, you're just going to be spinning your wheels here.
posted by something something at 6:02 PM on May 3, 2012


if the mother is actively using heroin, the teenager should not be living with her, full stop. I know Lisa is your best friend, but the child needs to be the priority. CPS should be involved.
posted by changeling at 6:05 PM on May 3, 2012 [20 favorites]


Children should not be living with junkies. I think that has to be made the highest priority concern here.
posted by Cosine at 6:09 PM on May 3, 2012 [4 favorites]


Helping her is not synonymous with "get her what she wants." She needs help, and her minor child needs a safe and supportive home environment. I would call CPS, personally, if the ER didn't do it.
posted by SMPA at 6:15 PM on May 3, 2012 [4 favorites]


How old is the teenager in question? 14? 17? There's a big difference in terms of number of years left at home. Are there relatives for the kid to stay with? Can the kid bunk with you until mom is out of the hospital?

In any case, your friend needs to get to an ER and get medical treatment and will not be able to adequately care for a child while doing so. It's really unfortunate that this is the case, and I hope that CPS doesn't *have* to be involved - but this is a situation where the kid needs a caretaker and mom very much is not able to do that right now.
posted by sonika at 6:33 PM on May 3, 2012 [3 favorites]


Your primary responsibility, as someone who knows about their mother's unstable heroin use, is to the child. Full stop.

The kid is legally, financially, emotionally, and logistically completely dependent on your friend and needs help. Depending on the kid's circumstances CPS may not be the kid's best option, but that is unlikely and worth figuring out.
posted by Blasdelb at 7:34 PM on May 3, 2012


No one can guarantee that the ER will or will not call CPS.

I'm nearly certain the ER will not help her - most do not consider standard opiate withdrawal an emergency. At the very best they may stabilize her for a few hours before discharge. This is very rare in my area.

Please do not send here there. It will be next to useless.

Try to encourage her into treatment. Drug treatment facilities have a much better grasp on when they must and can't call CPS for child abuse and neglect. She won't get the same knee-jerk reaction you're seeing here about being a drug addicted parent. I won't get into all of the confidentiality laws...but the short version is that being a parent and a junkie are simply not enough for treatment facility staff to make a CPS report.

There is no get out of jail free card with opiate dependence, but there are options. She can try a detox facility. This can be a pretty rough landing, but better than kicking on her own. Buprenorphine, Suboxone and methadone are also options. All of the medications out there used to treat opiate dependence have very specific benefits and drawbacks and have different success rates with different kids of people. Memail me if you want more detail.

I work with a lot of heroin addicts. Your friend's story arc is very familiar. She is accurate when she said that heroin is cheaper than other narcotics.

That said, the most familiar aspect of the story is the front loading details - chronic pain, buying off the street, falling in with a bad dude who got her into the bad stuff. They suggest she's not really like other drug addicts, just someone who got hooked on heroin through an unlucky chain of events and who needs to get through the physical withdrawal to be okay again. This is rarely the case.

Get some treatment referrals and information. See how she responds. Keep an eye on the kid. Take the next move as it comes. You may have to call CPS at some point, you don't have to make that decision now.
posted by space_cookie at 7:36 PM on May 3, 2012 [9 favorites]


This's a super-crummy situation, but, it doesn't sound like you have a good grasp on how messed up your friend is. Unless the kid is close to 18 and functioning well, I don't understand why you wouldn't want social workers involved.

She isn't using it to deal with pain -- she's a junkie. She's schtupping a junkie! "She is going down this path because of dealing with chronic pain" is bullshit.

FWIW, I have been taking assorted painkillers for joint problems for the last couple of years. Some very strong -- I tried a fentanyl patch. Worked great and I was no longer crippled, except I found myself going up dosages, and when it was nearing time to change the patch my body was nothing but MORE DRUG NOW! Obviously an untenable situation. So I got my man to score me some h... No. I talked to my doctor and went off the stuff. I spent a few days barely able to move, a few days with what felt like an awful flu, and a few weeks weak, and that was it.

I did think about how my experience might relate to street users trying to kick; I had a lot of advantages -- a supportive physician and prescriptions for things to ease 'restless legs' and to sleep, a freezer packed with nice meals for my "detox," supportive friends, the ability to take a few weeks off of most sorts of functioning -- it would've been quite a different deal. However, later on I tried a different opiate patch, and, again finding the side effects unpleasant, went through a milder "detox" again. So long as one is not living under a bridge and is not getting one's jollies from the stuff...I mean, you must on some level realise that lots of people have chronic pain, take medications to deal with it, and eventually stop taking them.

Happy to be corrected by somebody more in the know, but I don't think this is ER stuff. (On-line discussions there and elsewhere suggest little good will come of it.) She should talk to the physician who was prescribing the Dilaudid to discuss things, but -- I do not know how ERs handle junkies and this does not sound like something one visits the ER for; what does she fancy they will do to magically get her to stop scoring junk? She should look into clonidine but, again, prescribing physician; there's no point in clogging up an ER with a non-E issue...

Anyway, if she is up for a couple of crummy weeks and you've got the time and resources to deliver some food [junk food and vitamin pills, probably; detox is very nauseating] and do whatever needs to be done for the kid, she can get off this stuff. But all signs point to her enjoying being on drugs -- I don't mean she likes being an addict, but I mean the fix feels good to her. One does not casually make a decision to start shooting up; one does not shoot up thinking "This will be a good therapy to manage my backaches." She sounds like she wants a fake way to address the situation and the magic ER idea (but oops, can't go, even though there is no point at which one is required to present one's parent ID during an ER visit), not a drug-free life. I...ach, sorry, the ER was YOUR idea? It kinda sounds like she has little interest in getting off the stuff.

Googling will provide a wealth of tips and tricks for DIY detox and the prescribing physician should be able to step up and prescribe a few non-narcotic things that will make it easier. This isn't that complicated -- unless she doesn't want to do it, in which case, social workers are needed if the kid is on the younger side of 'teen.' Forget her own issues for a second -- that she has seen fit to ball a jailbird junkie while trying to parent is pretty dreadful, no?

A social worker could be useful not to take her kid away but to help sort out logistics with getting her housing and income and so on, which would certainly make detox easier. Social workers do not generally leap to snatch kids from detoxing parents, just actively using ones. You and her need to figure out which she wants to be. Good luck; a very sad story.
posted by kmennie at 7:37 PM on May 3, 2012 [1 favorite]


Unless your friend is in immediate physical danger, I would not suggest going to the ER until I knew whether or not the ER is mandated to notify CPS and how the ER handles patients in need of addiction treatment (e.g., will the hospital help the patient get admitted into a treatment program, release after detox with a list of phone numbers for area facilities, etc).

I agree that the child's welfare is top priority, but if VA CPS is anything like what we have in IL, the last thing your friend's child needs in their "assistance".

What you can do for her 1) identify available treatment options for her situation, including how to pay for treatment, 2) find out what happens if/when CPS becomes involved, 3) help her identify options for caring for her child.

Here's a place to start phoenixhouse.org (seemed to be the most professional and informative of the responses to googling "addiction treatment metro DC").

Your friend is lucky to have you. Good luck.
posted by she's not there at 7:44 PM on May 3, 2012


There is a lot of uninformed and misguided advice about addiction being slung around.

A person who is addicted to opiates needs, first and foremost, treatment. Probably methadone treatment. There doesn't seem to be any methadone clinics in Fredericksburg, but there are some in the area. Lack of transportation is going to be an obstacle. Take a look at this Google search for methadone clinics in the area that might be options. There is a great deal of stigma and mythology surrounding methadone but it is probably her best shot. I hope you will educate yourself and talk it over with her. An appointment with a social worker knowledgeable about addiction services would be an excellent first step.
posted by reren at 7:47 PM on May 3, 2012 [1 favorite]


Not sure exactly where you are, but based on the DC reference I did a quick Google search for Access to Recovery programs in Virignia. I didn't find an official ATR program currently in place but the Fairfax-Falls Church Community Services Board provides support for mental health and substance abuse issues. I would suggest getting in touch with them, or, if that is not your area, a similar type of organization. Almost all local governments have an agency like that and they are probably best equipped to answer your questions and point your friend in the right direction. Best of luck to you & your friend.
posted by katemcd at 8:04 PM on May 3, 2012


I was going to suggest what katemcd did. You can search for something closer to where you are on this site: http://www.dbhds.virginia.gov/SVC-CSBs.asp
Best wishes to you and your friend and her children.
posted by NikitaNikita at 9:22 PM on May 3, 2012


It is very easy to fatally overdose on heroin.

It's a pretty easy decision between "child spends some time with CPS + has a mother who lives" versus "child stays with mother and finds mom dead from an overdose."

The decision to get help is the easy decision. The hard decision was made a long time ago, when she started shooting heroin.

You must intervene. She can't get out of this of her own volition, and you have to protect the child.
posted by jayder at 10:21 PM on May 3, 2012


I think you need to consider beyond the next ideal step of "get her help" -- because, what if that doesn't work? What if she won't go? What if she goes, but then runs out? What if she goes on the methadone but -- like a lot of junkies do -- keeps using heroin?

People very, very, very rarely get clean on the first try. So, what next?

Now, about the kids: you've said nothing about Lisa's family -- does she have any? Are they good people? Can they step in and take the kids?

Finally, though, you ought to ask yourself why you want to take on this situation, because it's a freakin' mess. In for a penny, in for a pound: whatever scenario(s) you're imagining, you're not even close to what reality will entail.
posted by gsh at 6:50 AM on May 4, 2012


There is a lot of uninformed and misguided advice about addiction being slung around.

This is really true. Your friend needs help. Addiction is a disease, and it really doesnt matter how she got where she is at, but where she wants to go. Not saying trust a junkie, but many people will seek drugs particularly when their script runs out. Having chronic pain, and not having adequate relief will cause patients to seek relief from anything and everything. I've sought out medications when mine run out either because I can't get a script renewed, or insurance issues. It isnt some moral failure, it is a societal and cultural problem. No doubt the component of opiate usage becomes regularly demanded by the body is an aspect to consider.

Also just because someone is an addict doesnt necessarily mean they cannot be a fit parent. Many people have children and are alcoholics or 'legal addicts' of speed and opiates. She should seek a program, probably one dedicated towards women with addiction problems and get this monkey off her back. The ER wont help, and she should maybe speak with her PCP if possible about the problem. Yet framing is important, and she should be careful depending on her relationship with her Dr.

Just have to add my two cents, this thread is full of bullshit and dehumanizing of an individual who has a serious health problem, not a moral failing.
posted by handbanana at 8:25 AM on May 4, 2012 [3 favorites]


Also be a good friend, but don't help her fund a habit, nor give her material support to continue down this road. If she really wants help, help her find resources in dealing with this problem. Perhaps offer to watch her child, or find a clinic.
posted by handbanana at 8:28 AM on May 4, 2012 [1 favorite]


What handbanana says, in spades. I don't even know what to say about all this self-righteousness. Heroin seems to be a trigger word around here. If she were hooked on MD prescribed Oxycontin would the condemnation be the same? Would people be suggesting her kids would be better in the CPS system? I don't think they would.

Yes, a stoned parent isn't an ideal parent. Neither is a parent who's in chronic pain. She's damned if she does and if she doesn't. Our system is fucked up around pain, thanks to the War on Drugs (tm).

I agree that she needs to get off and get legit drugs, because until she does, she's vulnerable to losing her kids. If she has chronic, debilitating pain, she may never be 100% "clean" again, and that's okay if it means she can function. But she should be on government approved pain meds.

If she doesn't have insurance, I'm not sure how that would happen. I know around here, in California, there are drop in centers (I'm thinking of one run by Goodwill, called Interlink) that at least knows what resources are around for her. This might even be a case where you calling 211 would be useful (leaving out identifying details.)

The ER won't do anything good and they may feel obliged for CYA reasons to get CPS involved. Stay out of it, except to help her research options, if she wants it. She probably feels trapped, justifiably, between her pain, her pain meds, the legal system, and the public shaming that the word heroin brings out in people.
posted by small_ruminant at 10:27 AM on May 4, 2012


Have YOU thought about going to Al-Anon? That is one way to get started. Get her child to go to Alateen.

Also, I'm with the crowd here, hanging with a junkie in sketchy housing isn't doing her child any favors. I agree, the foster system is a BAD alternative, but surely there's a relative or a friend who can pitch in?

Now, your friend needs a program. ER isn't the place for this, a social service agency is. (My dad ran a methadone clinic and a Drug Abuse family counseling program, so I've got some experience via osmosis.) Folks have linked to some in your area. There may be a waiting period, so what's the plan until a bed frees up?

Again, it's great that you want to help, but you have to know what help IS, so hie thee to Al-Anon.
posted by Ruthless Bunny at 10:58 AM on May 4, 2012 [1 favorite]


For those who say "don't call CPS" I will day: heroin isn't even close to this kid's only parent problem, even assuming the question actually stated all the relevant issues.

But yeah, the ER is going to be useless. Try your local social services hotline (often 211) if the numbers listed above don't work.
posted by SMPA at 2:08 PM on May 4, 2012


For those who say "don't call CPS" I will day: heroin isn't even close to this kid's only parent problem, even assuming the question actually stated all the relevant issues.

We really don't know.
posted by small_ruminant at 2:46 PM on May 4, 2012


Mod note: From the OP:
First, quick answers: She asked for help. She is taking care of her child, I am in contact with the both of them multiple times per day. CPS will do nothing other than send her child to her bio Dad's home. He is not a good fit for this child, believe me, if he was the child would be going there.

We looked at this with no idea of what to do as this is a new situation. She has very little family, none of whom can help her. We can't afford to move her daughter in here. If we could, I would, and she actually asked me to take her for a month. There's just no way financially.

She went to the local CSB this morning. She is being started on Suboxone and therapy ASAP. I worry about her daughter being with her while she does this, but sometimes there aren't many choices in life.

Lisa is a good Mom, she really is. I wish I could impress upon you all how great of a person she is. This drug problem is literally less than four months old. She is getting help already, thanks to suggestions here of what to do.


"She isn't using it to deal with pain -- she's a junkie. She's schtupping a junkie! "She is going down this path because of dealing with chronic pain" is bullshit."

I have seen the x-rays of her back and neck, she is definitely in pain. Had you seen them you would understand.

Having said that the boyfriend is someone she went to high school with. He was not using when they started dating, or living together, he had a relapse following emergency surgery for a serious issue that almost killed him.

By the way? Junkies are people too.

"I was going to suggest what katemcd did. You can search for something closer to where you are on this site: http://www.dbhds.virginia.gov/SVC-CSBs.asp "

This is the type of help I was looking for.  Neither of us have ever dealt with anything like this. We don't know the resources. There is a CSB that we have actually dealt with for other things, I did not realize that worked with substance abuse issues, thank you.


"Finally, though, you ought to ask yourself why you want to take on this situation, because it's a freakin' mess."

She's my best friend. If you can't try to help your best friend, what can you do in this world?


Other issues in case anyone has any other ideas:

Her teen daughter is bipolar. She lost the man who was her Dad (not bio father, but her Daddy) to suicide 17 months ago. We cannot let CPS take her, she would not be able to mentally take that. Her bio Dad is a jackass who treats her like shit due to her mental health issues.

I have contacted an Al-Anon group for myself. I know I am deeply involved with this. I love Lisa like she were my sister and I'm doing the best I can to help her.

Thank you to everyone who is looking past the drug she is taking and to the person she is.
posted by mathowie (staff) at 4:18 PM on May 4, 2012 [2 favorites]


Thanks for the update, and good for you for helping out. Take care of yourself. (Al-anon will help.) If you keep your own oxygen mask on, you'll be better use to them. It sounds like you're there already. Don't be afraid to call on all of your own resources to support yourself. This kind of thing is rough even on the helpers.

Your friend will benefit from an ongoing program or support group- it's a hard row to hoe to balance out chronic pain and pain meds, and the balancing act is something that won't go away unless her pain goes away, and it doesn't sound like that's likely.

FWIW, a hell of a lot of the 12 Step groups, which I love and highly recommend for you and for most people, have a hard time with this. If you're at all familiar with ACA and addictive thought processes, it won't surprise you to learn that many of their members tend towards black and white, all-or-nothing thinking, including pain meds.

Al-anon has been the exception to this, ime. Narcotics Anonymous, though, as an example, has a rocky track record with it.

Best of luck to you and her. It's totally do-able, it'll just be a PITA for awhile, same as a lot of medical conditions.
posted by small_ruminant at 4:53 PM on May 4, 2012


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