I was running a group for court-mandated clients with substance abuse problems, and we were talking about triggers, the things that make them feel the urge to use their drug of choice. One person mentioned holidays. Another person mentioned anger. A third person referenced beer commercials. And then a fourth person said: "Turners Falls."
I stopped a minute, stunned. Turners Falls, which was not in the same county or even the same state where this group was being held, is a sleepy New England village with a population of less than 5,000. It is also my hometown. I looked at the person who'd said it, wondering if a) he was serious, and b) he somehow knew where I'd grown up.
Before I could read much in his eyes, though, a couple of other guys chimed in, talking about their drug-related ventures to Turners Falls or its neighboring towns and how they, too, now consider these places to be triggers, associating the places themselves with the use of drugs.
I'm not sure why I felt so surprised. Addiction is a life-threatening, tragic, and exorbinately expensive public health problem which has reached epidemic proportions. Recent figures from the Centers on Disease Control show a staggering increase of heroin overdose fatalities, for instance: in 2012, it was the reported cause of death for 5,927 people in the U.S., but a year later, it was the reported cause of death for 8,260, a 39% increase in a one-year period.
And heroin addiction is by no means the only national substance abuse emergency. Prescription medication overdose fatalities have also sharply increased, especially among women, and excessive drinking is the fourth leading preventable cause of death in the U.S., causing an estimated 1 in 10 deaths among "working age" adults. (I have my qualms about the CDC category "working age", but that's for another blog at another time).
Addiction is a multi-faceted problem which is destructive in many more ways than can be captured in cause of death statistics. It is a direct and indirect cause of violence and other crime, damages and sometimes destroys families, costs us billions in incarcerations and emergency medical treatment, and interferes with workplace productivity and relationships. It causes chronic and acute health conditions. It can lead to suicide and homicide. Often, it becomes a source of despair and self-loathing.
The problem is worsening, and there is not enough help available. In 2014, Vermont governor Peter Shumlin devoted his entire State of the State address to a discussion of Vermont's opiate addiction problem. People paid attention, and the states's budget for addiction treatment was more than doubled. Treatment resources were expanded, as promised. But a year later, treatment facilities there still have waiting lists of hundreds. Even with expanded resources, demand is still exceeding supply.
We need to understand that addiction is everyone's problem, and that it requires a sustained and committed response.
When I was a teenager growing up in the inocuous little mill town which is now a perceived trigger to some people recovering from addiction, I heard for the first time the analogy that addiction is like the elephant in the living room. It was described as a problem affecting certain families that was both so huge and so shame-inducing that families would tiptoe around the "elephant" without acknowledging to one another that it was even there. At the time, I thought it was a powerful analogy, and felt grateful it applied to other families, was not a factor in my home.
Today, addiction is not an elephant in the living room. It is a tsunami bearing down on our communities. If we underestimate its magnitude and ignore its size, it will drown us before we can say "home town". It will demolish us while we stand pointing our fingers . at those other, troubled communities where addiction supposedly lives.
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