Endless cycles of problems, drugs, addiction, treatment failure and associated crime plague our society, but what about the real victims? Are we so focused on solving these problems faced by our community that we are overlooking the real cause? When it comes to treating drug addiction it seems we can no longer see the wood for the trees.
Think again. A solution is right before our eyes. A treatment that combines a medication that reverses physiological addiction with a philosophy that recognises and targets the underlying problems is having remarkable results in Australia. Two young women, once in a downward spiral of addiction towards an increasing risk of death, are alive and recovering today because they discovered the truth like many others. Their names have been changed in the following stories to protect their privacy.
Sonja is a recovering heroin addict currently undergoing treatment at a Perth-based facility. During interview she revealed that she was born addicted to heroin as the baby of a heroin-dependent prostitute; immediately stigmatised from birth. She was not like the others at school; her own identity was rejected leaving her vulnerable to constructing the first stage of an alternative identity, the biggest risk factor for drug use.
Proximity and opportunity for drug use is the next risk factor. A close family associate recruited Sonja into the drug scene at 11 years of age which marked the beginning of the second stage of her identification with the drug subculture. Child Protection Services, alerted by Sonja’s teachers, removed her two younger siblings yet left her behind in a damaging environment. Neglect and failure by bureaucracy to offer her the protection she required to develop under normal conditions meant that she was denied acceptance into mainstream society.
Other types of forced identity change are known to impact on the persistence of drug addiction. Sonja underwent a further identity change at age 17; that from daughter to mother. Child Protection Services returned, although on this occasion they took away her baby daughter. This third stage in her identity crisis cemented her heroin dependency and membership within the drug subculture. She was placed on the methadone program where her addiction was ‘managed’, however she relapsed regularly.
After three more years of sustained addiction with methadone Sonja discovered by accident the name of the addiction medicine specialist who would offer her a means of breaking her addiction with his controversial naltrexone implant therapy. Naltrexone reverses the physiological addiction, renders heroin and methadone ineffective and therefore refractory to abuse. Sonja says the cravings for heroin disappeared from the moment the naltrexone implant was inserted under her skin. Professionals at the Fresh Start facility also offer her access to structural supports for self change, the belief that she has the power to change and social supports required for that change.
A second interview with 18 year old Anita revealed some similarities. She had been diagnosed with ‘borderline personality disorder’ as if her own personality and identity are defective as opposed to the precipitating conditions to which she was subjected. During interview she related her stressful childhood under the control of a father with chronic obsessive compulsive disorder. His constant and excessive controlling behaviour towards her, an example of loss of control over one’s identity, meant that she developed under high levels of stress.
Anita’s own excessive and manipulative behaviour meant that she was excluded from developing friendships with ‘normal’ children. She invented stories aimed to shock and gain attention from those who would otherwise ignore her. For example, her articulated ‘ambition’ in life since the age of 11 has been to be dead by 21. She played elaborate games of attempted suicides in creative and dramatic circumstances, none of which could ever have been successful. Despite having been informed by a doctor how to end her life more efficiently, she has never taken his advice. It seems that she would behave in this way in order to impress or entertain others. The self that has experienced rejection in society leads to behaviour that minimises self-derogation and maximises self-acceptance or acceptance in the eyes others. Therefore she engaged in manipulation in order to gain acceptance and even attempt to redefine events and create alternative realities, not realising that she had the power to redefine herself.
She associated with other ‘deviants’ who gave her the peer-approval and acceptance to identify with the drug subculture to which they belonged. She developed an addiction to heroin at age 14. Two years later she formed a relationship with a convicted paedophile, to whom she was 4 months pregnant at the time of interview. He abused her yet she stayed with him because it was preferable to being alone. When asked why she doesn’t look for someone who will respect her, she responded with quiet disbelief; that possibility had never occurred to her. Respect and happiness is not for people ‘like her’. She believes the negative identity that has been assigned to her by society.
Like Sonja, Anita was also experiencing an additional forced identity change from daughter to mother. Fortunately this pregnancy served as the trigger for intentional self-change instead of contributing to her demise. Child Protection Services intervened and expressed their intention to remove her baby at birth. Fortuitously, her obstetrician was also the same addiction medicine specialist working with naltrexone implants. After five months recovery at a Fresh Start facility and naltrexone implant therapy, Anita has fought against her addiction and has been allowed to keep her baby.
There are many success stories with naltrexone implants and the Fresh Start Clinic in Perth, Western Australia. The time it takes to heal is dependent on the strength of the addiction as well as individual circumstances and general psychological state. All these criteria are addressed as part of a prescribed and personalised treatment plan. Where there’s a will, there is now a way.