Every Tuesday night we gathered around a table in a stuffy room of a dilapidated community centre in suburban Sydney to tell the stories of our addicted children. Stories that often sounded like clichéd storylines from the plot B of police procedurals: of the 16-year-old scholarship girl prostituting herself to her dealer, the former captain of the school football team whose arms are bruised black with perforations, the daughter who begged for a five-minute cigarette break from her mental health unit in order to score from the ice dealer who hangs around the hospital gate.
Occasionally the 20 mothers, fathers and grandparents talked about the potential for a dramatic TV series based on their tales of sex, crime and drugs. But at other times the stories seem so tired and repetitive that any screen version would risk resembling a Latin American-style soap opera.
Because these families are constantly living the drama – rather than watching it – it has taken an inordinate amount of time to transfer the meetings online with the advent of Covid-19. Unsurprisingly, the stories have continued uninterrupted in the meantime, the most common recurring theme being the revolving door of the emergency department – how the floridly psychotic son or daughter was again turned away – occasionally with an anti-psychotic prescription – but never with a long-term treatment plan. Because they’re just drug addicts after all. And everyone knows that if you take drugs it’s your choice. As though, during the secondary school careers expo, a series of options had been laid out in a row of booths labelled Nurse, Engineer, Teacher, IT Specialist or Ice Addict, and their children had made a beeline for the addiction stall.
Recently, one mother told the story about how two police officers were being employed to turn up every morning at her schizophrenic son’s boarding house to administer his anti-psychotics, which he keeps in the same drawer as his ice implements. (Approximately half of addicts suffer from serious mental illness; the medical profession cheerfully call it co-morbidity; the services describe it as dual diagnosis.) But long before the law gets involved – which is almost an inevitability given that addiction is effectively a crime – it is the family who are the the first responders.
And it is the families who are ultimately considered chiefly responsible: responsible for the waywardness of their adolescent children, responsible for getting them into rehab, responsible for receiving them back into the family home when they return from rehab, and responsible, to some extent, when they relapse. They are also overwhelmingly responsible for the medical appointments and fees, health insurance, accommodation and nourishment of their mentally ill addicted loved ones. And of course what we really mean when we say families is women. “Women inside and outside families, women struggling, often with meagre resources,” writes Barbara Taylor, author of The Last Asylum, “to look after loved ones who are too crazy … to look after themselves.”
And yet these families have almost zero support. And that’s because many people believe that we parents are also responsible – in some deep way – for our children becoming addicts in the first place. Therefore, it’s our problem.
We hear a lot about ice busts and the war on ice but we don’t hear much about the mums and dads, the brothers and sisters – about these particular quiet Australians who are living with the ongoing chaos of relatives “active in their addiction”. The main reason we don’t hear about the families is because they are too ashamed to speak up.
A recent Carers NSW initiative is attempting to reach out to families of addicts through the “Hidden Carers Project”, but few have been brave enough to out themselves. We may titter when a colleague turns up on a Monday morning with a killer hangover but just try mentioning your partner or sibling drying out from alcohol or methamphetamine and the tea room will empty instantaneously.
Over the years, the secret support group has shared countless anecdotes about attempts to reveal their problems to, say, a colleague or a neighbour, only to find themselves frozen out next time they run into them at the hairdresser or the supermarket. Because your neighbours and co-workers know the shameful truth: if your kids are addicted it’s clearly because you, as a parent, did something wrong.
It would be reasonable to assume that the health system, with its well-educated doctors and professionals, might offer help to families of substance users. But individuals involved in health care frequently suffer from the same “druggie” prejudice as the rest of the population. The medical profession has a hierarchy like everything else, with surgeons and anaesthetists at the top, and the treatment of people with drug and alcohol problems on the bottom rung, just below mental health.
It’s partly because of these complicated and covert philosophical doubts about whether addiction is a disease or a personal moral failing, that it has taken so long to realise that addiction is a condition that is treatable and that addicts can and do recover.
Unlike other illnesses, recovery from addiction is highly individualised and complex and in the case of ice, which is affecting our young people more than any other illicit drug, there is no agreed treatment model. One of the few certainties in the treatment of addiction is that the support of family is often crucial to long-term recovery. And yet families are frequently locked out of conversations with doctors about treatment. This is despite research showing that involvement of families or “networks” leads to better outcomes, a fact that is recognised in effective, holistic approaches to the social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples and the Maori concept of TeTaha Whãnau (family health). These approaches offer a better structure for responding to addiction but would require fundamental change to current models.
One small way of recognising the current reality for tens of thousands of families across Australia is to give them a rest from the constant chaos caused by the common combination of addiction and mental illness. Three years ago carers in crisis in Sydney could apply to go to the sole respite centre. For a few days they were accommodated in a cabin and this brief break could make the difference between a family’s survival and its disintegration. That service, like so many others around the country, is no longer available.
There is a romantic idea that a crisis brings a family closer together; the reality is that if the crisis is unrelenting, families often fall apart. We need to stop expecting parents to double as psychologists and therapists, and stop treating their homes as unfunded rehabs. This means making the pathway to treatment – offered almost exclusively by private clinics and non-government organisations – much less of an obstacle course-cum-minefield-cum-lucky dip.
Addiction may be a problem of the individual, just as a diagnosis of Covid-19 is a personal problem for the individual infected, but the solution, like the solution to our current pandemic, is collective. If we could establish an agreed treatment model based on expert medical advice, as we have with the coronavirus – enlisting the understanding and cooperation of government, families and the citizenry – it is possible that the tens of thousands of families all over the country currently looking for support in the back rooms of rundown community centres, might finally find some relief.