by Michael Adams
The second in an ongoing series of articles about Long Island’s Heroin Epidemic.
LONG ISLAND, NY- Jeff comes from a long line of addiction.
Both his father and his grandfather were alcoholics, he lost a son to a heroin overdose just over a year ago. Himself sober more than three decades, his life has endowed him with a unique perspective. Having seen the views of outsiders change over the course of four generations, Jeff has a context for the evolution of the stigma surrounding addicts like few people alive today.
“I grew up right by Creedmoor, right across the street,” Jeff said. “My grandfather was committed in his fifties. He spent the end of his life drooling into a cup. I lived across the street from my grandfather my entire childhood, and nobody ever told me until much, much later, after he’d already passed. He’d been committed for insanity; in the eyes of the community, it was better to say the man was crazy than to say he was an alcoholic.”
Decades later, the names have changed, and the situations have improved, but only somewhat. Addicts aren’t sweating out the end of their lives in mental institutions, but the stigma remains, strong as ever.
Understanding the information behind the crisis gripping Long Island is crucial to coming up with any sort of solution. According to the 2014 edition of the Drug Abuse Sourcebook, poisoning is the leading cause of death from injury in 30 states. Nine out of ten poisoning deaths are caused by drugs, and the total number of casualties has surpassed the total number of traffic fatalities every year since 2008. The overdose death rate for men has more than doubled since 1999; it has more than tripled for women.
The medical textbook gives a number of explanations for the sharp increase in deaths from drug abuse since the turn of the century. Among them are the presence of adulterants such as fentanyl, which is many orders of magnitude stronger than heroin, in the drug supply, the short length of insurance covered stints in rehab, over prescription of painkillers and the lack of available beds in treatment facilities. Though seemingly a contradiction, the Sourcebook also lists both the practice of doctor shopping (where users visit multiple doctors to obtain medication) and the government crackdown on doctor shopping, which has led desperate addicts to the streets, as further causes of the nation’s heroin epidemic.
In a textbook read by prospective medical students, these words have the feeble power of any other statistics. It is the painful reality of addiction, the stigma, the suffering, and the loss, that truly shed lights on this latest iteration of a crisis as old as civilization itself. The primary focus of this article will be the stigma of addiction, the judgement and misinformation that permeates all levels of an addict’s struggle, and stands as a serious obstacle to any sort of solution.
Despite the daunting scope of the heroin epidemic on Long Island, there is a strange silence that surrounds the deaths of many addicts. No obituary in the newspaper, no quick segment on News 12, no mention whatsoever of the cause of death, even from the parents themselves. Even when the entire community has a solid notion of what happened, ostensibly, it was a car crash.
Anthony Rizzuto is a social worker for the Seafield Center, and the Executive Director of Families in Support of Treatment, or F.I.S.T., a not-for-profit organization that works to organize families to fight back against the obstacles to the treatment of addiction. Rizzuto explains that parents of an addict, either dead or living, often have a hard time coming to grips with their situation. “Parents always blame themselves,” Rizzuto said, “they say things like ‘maybe if I would have gotten him that bike, things would be different,’ when you admit your son is an addict, it seems like a personal failure.”
Rizzuto went on to explain how addiction can affect the family of an addict as much as the addict themselves.
“I’m a treatment professional,” Rizzuto said, “I’ve been working at Seafield for the last fifteen years, and I believe addiction is a family disease. I believe that it’s not just the person with the addiction that suffers; if you are the sister or the brother of somebody addicted to heroin, or whatever, you go through a whole slew of changes in your world. You get a 90 on a test, your parents don’t even know you’re alive. You’re being sworn to privacy when you find out they’re doing what they’re doing. And you don’t want to rat them out, so you’re holding on to the secret, but you’re terrified. And then mom and dad are at odds because dad wants to take a hard line and mom wants to coddle them, so sometimes they start going at it. The whole family dynamic starts to change.”
The ordeal the family of an addict is put through is harrowing, and they certainly can’t be blamed for electing not to broadcast the cause of their child’s death in a world where addiction—which is defined as a mental disorder in the medical community—is still looked upon as a moral failure on the part of the user.
However, that same reluctance to publicly acknowledge an overdose death is what contributes to that stigma in the first place. Linda Ventura, a native of Kings Park, lost her son Thomas to a heroin overdose in 2012. Afterwards, she made a choice grieving parents can make: not only did she admit what had happened, she became a front-line soldier in the fight against drug addiction on Long Island. Linda is on the board of directors for F.I.S.T., she has shared her story with Newsday and other outlets, and has spent years advocating for treatment reform on the level of state and local government. She believes much of the stigma surrounding addicts comes from a failure to understand the illness of addiction, as well the erroneous image of the drug addict that many people have in their heads.
“It’s a disease that he suffered with,” Ventura said. “If anybody thinks Thomas woke up one day and said ‘I think I’ll shoot heroin and kill myself,’ that’s not at all what happened. It was a progression, and that’s not who he wanted to be, and that’s not who he was. There’s Thomas, my son, who I miss every second of every day, and there’s Thomas the addict, and if he were standing in front of me I’d say ‘you’re a mean, selfish, son of a bitch that I don’t miss any second of any day’. There’s the person and there’s the addict, and if people could understand that things would be different. Blaming him for being an addict is like blaming him if he got diabetes.”
Linda Ventura Speaking to Suburban Heroin About the Death of her Son
Linda also described her experience writing about her son for Newsday, and reading the comments people made about him. “People think it’s a moral choice somebody makes. Thomas made one mistake, one time, that set his disease in motion. When I read some of the comments I had to take a step back and just tell myself to let it go, because of the ignorance. ‘They deserved that,’ ‘they deserved to die,’ nobody deserves to die.”
The stereotypical image of the alcoholic or the drug addict that comes to mind for many is the Bowery Bum. When people think of an addict, they picture a person completely disheveled, mentally unhinged, and willing to do anything for a fix. According to Ventura, this view of the addict as an “other” is one of the biggest sources of stigma around addiction as a whole. An image closer to the reality of a victim of Long Island’s heroin epidemic isn’t the Bowery Bum, it’s Natalie Ciappa, the cheerleader and honor student from Massapequa who died of an overdose back in 2008.
“I think what people do is they have this mentality of ‘not my kid, not gonna happen,’” said Ventura, “they refuse to see signs and symptoms when they’re very much in their face. Most parents I speak to always say ‘well that’s not my family, my kid won’t do that,’ and I would challenge them to give me five reasons why not your kid. There is no kid that is bulletproof in this world. Kids take chances, kids don’t know, because they’re kids.”
Anthony Rizzuto echoed a similar experience when it comes to the views of people who had no personal experience with addicts or addiction. “If you look on TV, any time one of the characters is a drug addict or an alcoholic, they’re usually disheveled, possibly violent, committing criminal acts and engaging in deviant behavior. They’re not seen as a father, they’re not seen as a son, or a doctor, or an attorney. There’s addiction in all professions, it’s endless. But there’s a selective criticism to show this deviant behavior, and it leads people to have this perception of ‘oh, I don’t want any of them around me.’”
The stigma that an addict faces can follow them their entire life, even after they enter recovery. For Jesse, a recovering addict from Plainview, life in sobriety has still meant suspicions and accusations from his family. “My brother was home from Washington,” Jesse said, “as a kid, he used to take money out of my mom’s purse here or there. I never did that in my life until I became an addict. On the last day when he leave, forty bucks was missing out of her wallet. She doesn’t say anything, but a week later I’m getting screamed at because, of course, it must be my fault. It feels immediately like ‘oh, let’s blame the junky,’ don’t blame my brother, who’s done it a thousand times, just blame me.”
Even though Jesse is picking up the pieces of his life, the shame of active addiction still lingers in the back of his head. “Even though I didn’t do it,” he said, “there’s still that shame from knowing that was me, I was doing those things. And there’s nothing I can really do to make up for it at this point.”
In most cases, the suggested path for treatment of an addiction to drugs or alcohol is entering a rehabilitation center. Unfortunately, this road to recovery is often mired in bureaucratic red tape, and can be plagued by the same lack of understanding that characterizes the general populace. The run-of-the-mill length for a stay in rehab is 28 days, which for a long time was covered by health insurance and followed up by six months of out-patient treatment. These days, however, according to Rizzuto, 28 days is “unheard of.” Additionally, there are times when a patient is approved for a rehab or a detox center, but only after a waiting period that could range from a few days to weeks. Rizzuto feels this policy begets a poor understanding of the process of recovery. “When people struggle with the disease of addiction, part of the illness is the denial. When a person becomes willing,” Rizzuto claims, “you have to be able to seize that opportunity right away. Just because a person is willing today doesn’t mean they’ll be willing tomorrow, just because a person is willing at 3 o’clock doesn’t mean they’ll be willing at 5 o’clock.”
Oftentimes acceptance into a treatment center is contingent upon a guideline established by insurance companies or state legislatures. Even if in-patient beds are available—which is not always the case—an addict may have to fail an out-patient facility first, or meet what is defined as “medical necessity.”
“When a facility is looking at taking somebody in,” Rizzuto said, “they’ll often look at vital signs to determine if that person “needs” a bed. The problem is, when somebody’s high, they’re sedated, their body is used to that feeling and they won’t be physically out of whack. Not to mention so many of these people are young adults and kids, really in their physical prime. These days if I eat too much salty food, I’ll have high blood pressure the next day. But these 20, 21 year old kids might not hit the numbers they need to hit even if they’re in the midst of withdrawal.”
The reluctance of government officials and insurance companies to change the guidelines for treatment has begun to change in recent years, but only after tireless work by people like Ventura and Rizzuto. Ventura likens the reforms that have been made to “putting a band-aid on a bullet hole,” and knows there is more work to be done.
A few years ago, before F.I.S.T. was a non-profit, members of the organization met with Senator Flanagan to discuss a change in the “fail first” policy with out-patient clients getting accepted to rehabs. As he began to talk about the difficulty of amending the rules as they were written, Linda pulled out a jar of her son’s ashes, set it on Senator Flanagan’s desk, and told him “this is what fail first looks like.” Sitting speechless, mouth agape in shock, Senator Flanagan turned into an ally for the movement that very afternoon.
As hopeless as the situation may seem, there has been progress made on the level of ending the stigma of drug addiction. When asked what people who want to help the situation can do, Ventura said “they can be empathetic, sympathetic, educate themselves, and empower themselves. We need to start being community minded, everybody’s going to have to come together to make meaningful changes. It’s not going to be any one person’s responsibility, it takes a village.”
“Fix You,” a Documentary Made by Jennifer Shepardson About the Struggles of her Brother, James, an Addict in Recovery
For anyone who is addicted to drugs or alcohol, or knows a drug addict or alcoholic:
Featured Image Credit Source: Livescience