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Thursday, September 17, 2020

What I Did That Killed My Son

The end of June marked my dead son’s 30th birthday. He died of an overdose at age 26, and marking his 30th birthday hit me hard, a reminder of all the landmarks he was missing. Heartsick, I stayed up most of the night before creating a video of Kyle’s life in pictures, which I posted on my YouTube and Facebook pages. (You can see the video here: https://youtu.be/IMy4qc5ZBWc.)

A friend commented, “[This is] a montage of love. If only love could have saved him.” Reading that, I had a sudden realization: I had created that video not so much to honor Kyle as to defend myself as his mother. 

Look! the video said. Here’s photographic proof that I was a good mom who signed her kid up for sports, took her child swimming, proudly encouraged his early career as a stand-up comedian, taught him to play board and card games until he could beat me with relish, celebrated him with big parties for every birthday and graduation, maintained a close, loving relationship with his admiration-worthy father even though we eventually divorced, read to and instilled a love of reading and writing in my son, took him regularly to the dentist and was proud he never had a cavity, took him skiing, taught him to be polite to older people, shared easy affection with him, took him on marches and volunteer vacations, encouraged the supportive bond he had with his little sister, went white water rafting and on rollercoasters with him, spent a lot of time camping, hiking and in nature with him, helped him get his driver’s license, taught him to love to dance and have fun, to treat women with respect, to climb trees, to wear his feminist shirt with pride, to be creative with his Halloween costumes, to love learning, to care about his family and friends.

I thought I’d just wanted to honor and remember my son’s life by showing him at every beautiful stage. But now I realized what I’d really wanted was to illustrate I did everything I could to help my son have a wonderful life. I wanted a video to prove that nothing I did caused my son to become addicted to drugs and eventually die of his disease. 

But, of course, I did many things that hurt and disappointed my son, none of which are featured in this video– but all of which have played in an endless, agonizing loop in my mind ever since my son’s death. Only because I have talked to dozens of other grieving mothers of overdosed children am I able to forgive myself for most of my mistakes—because I’ve discovered every mother of an overdosed child made different mistakes. None of us is perfect, but we were all pretty good moms, and there is no pattern of wrongdoing I can find, no one place I can point the finger.

All of which leads me to the only mistake I made that may have actually killed my son: At the end of his life, Kyle phoned me, desperate enough to ask for my advice. He had been trying to get Naltrexone, a drug that blocks opioid receptors, causing users to vomit if they take a drink and to feel no high if they take an opioid. Naltrexone started as a pill in the ’80s and is now available as an injection that can last six months or even a year. Kyle had stayed sober six months while getting a monthly shot of Naltrexone (known as Vivitrol); he knew the drug was helping because toward the end of each 30-day period, he started having drug dreams and cravings. 

Since then, he’d turned 26 and lost my insurance, then moved from L.A. to Las Vegas and discovered that Nevada’s Medicaid doesn’t cover Naltrexone for addicts. Like 21 other states, Nevada will only provide addicts with Methadone or Suboxone. This was infuriating to me. Naltrexone keeps addicts from getting high. Methadone and Suboxone, I thought, just make addicts dependent on a different opioid.

“Mom,” my son said to me at the end of our last phone call, his voice exhausted. He had just been released from detox after another relapse. He was essentially homeless; he and his girlfriend and their 2-year-old daughter were living in my mother’s house in Henderson, NV, and my mother wanted them out. My son’s girlfriend, though staying sober, he told me, was having bouts of rage at their daughter and refusing to look for a job. “Mom, I don’t know what to do. If I can’t get the Naltrexone the next time I go there, I’m thinking of just taking the Suboxone they’re offering me.” 

Did I say to him, “YES! Of course! Take it! Anything to keep you alive!” 

No. Instead, to my lasting shame and regret, I maintained a stony, disapproving silence. He knew I disapproved of Methadone and Suboxone, thought they were for weaklings who couldn’t beat their addictions on their own or who just wanted the state’s help to get high. 

So I said nothing. I let the silence extend. My son finally added, “I just don’t know what to do. I’m asking for your advice.”

If there were one minute in my life I could go back to, that would be the one. I wish I’d understood my son’s illness was terminal and would kill him within days if he didn’t take the Suboxone.  I wish I’d met some of the millions of people who are maintaining jobs, happily parenting their children, and living healthy lives by taking Suboxone or Methadone every day. I wish my silence hadn’t conveyed that I would look down on my son if he went that route. I wish it weren’t true that I would have looked down on my son if he’d started taking one of those drugs. I was ignorant, having only seen people on methadone as droopy head-nodders, and I didn’t understand the alternative was death.

Instead, after a sigh, I said, “If anyone can convince them to start giving out Naltrexone, it’s you, Kyle. You’re so eloquent. You can get them to change this policy—and just think of how many thousands of addicts you’ll be saving. Maybe hundreds of thousands! You’ll be changing lives.”

That was how I mothered him. I believed he was so special that even in the most desperate throes of his addiction, he could accomplish something for others. (We also spoke often of the book he would write about his experiences cycling in and out of the addiction-treatment complex, our hope that something meaningful could come from the years of relapse and new recovery and relapse and horror he’d been living.) Kyle claimed to have been dutifully trying to get this policy changed for weeks. The previous week he told me he’d spent all day Friday waiting to see the doctor considering his application for an exception to the no-Naltrexone rule. The staff said the doctor would see him soon and then forgot him. At the end of the day, they apologized and said there had been a mix-up, the doctor had left. They told him to come back the following Tuesday.

Or maybe that’s just a story my son told me. Maybe he had already given up and stopped asking for what they said they would never give him. I have no way of knowing, but I think his story is true. When he told me this story that weekend, my advice was to go back and try again.

The following Tuesday, at 4:45 a.m., he overdosed and died in a Best Western bathroom, biking distance from his grandmother’s home. He’d said he was going to a new job Monday morning but instead spent all day using. When he got home, he took out the garbage for his grandmother and was confronted by his understandably enraged girlfriend, who had been home waiting for him all day with their crying 2-year-old. Their daughter was having an eerie premonition, kept sobbing that her Dada was going to leave and never come back. His girlfriend smashed his phone into pieces and punched him in the face, abuse he surely felt he deserved. (Her punch left a dark bruise still visible on his cheek as I wept over his body in the coffin two days later. I didn’t blame her; we had all been furious at him, thinking he could save himself and enraged that he wasn’t doing it.) He left humbly, apologizing to his grandmother, and brought with him his anti-depressants, a pillow and blanket, fresh clothes, and his bike helmet, which suggests his overdose was not intentional; he seemed, based on what he packed, like someone who intended to keep living. But at that last moment as the Best Western cleaning staff was rousting him from where he was sleeping on the bathroom floor, telling him he had to leave, maybe for that moment he felt so defeated that he intentionally gave himself a fatal dose. Or maybe he just intended to get a little high for the road and miscalculated. We’ll never know for sure. 

I don’t think any of the other mistakes I made over the course of his life killed my son. While some of them –like my decision to leave his dad-- surely made my son’s life harder, I don’t think any of them made him a drug addict nor compelled him to take that final overdose. However, I do think I might have at least contributed to his death by not encouraging him to take Suboxone.

My wife reminds me that my son regularly ignored my advice; she wonders why I’m so sure he’d have followed my advice that day. But he was asking me to support him in what he’d already concluded for himself:  that there was no other way forward for him but medication-assisted treatment. I believe that when he heard my silent but deep disapproval of that path, he tried and failed to go forward without it.  

So my advice for parents of still-living addicts is this: celebrate your child choosing medication-assisted treatment. It doesn’t mean they’ve given up on getting sober. It means they’re choosing life. Many people are on medication for the rest of their lives for diabetes, high blood pressure, heart disease–why not for the terminal disease of addiction? Don’t send your child messages that you don’t believe he’s “really” sober unless he takes nothing at all. (Many 12 Step Programs, sadly, tell addicts that they can’t consider themselves sober unless they’re off everything, including the prescribed drugs that can save their lives; this, too, must change.) 

Surviving the disease of addiction is a lifelong challenge. More than half a million Americans have died by overdose in the past decade, and the only way I’ve seen people survive long-term addiction to hard drugs (crack, meth and heroin), aside from a few, rare just-plain-sober unicorns, is with medication-assisted treatment. (When my son told me the Narcotics Anonymous recovery rate was something like 5 percent, I paused, and then said to him: “Good thing you’re in such an exceptionally high percentile.” What a fool I was.) I encourage all of you to embrace this path as soon as you can wrap your head around it. Every needle your kid uses until they start medication could be the one that kills them. Stop waiting for your child to have super-human strength and just be glad there are medicines that can save their life right now.

As for my fellow grieving parents, the ones who share my terrible loss, who watched their sweet, gurgling babies turn into fiending strangers, my advice is to stop looking for what you could have done differently. Make yourself a moving, mournful video like the one I just made if it helps you to remember the good times and all the things you did right. Let yourself cry over how you’ll never experience those good times again, never hug your child again, never be able to stitch closed the wound your child’s absence leaves in your heart. But turn off that video running on repeat in your head of every mistake you ever made. Your child knows you loved him or her. In nearly every case, your child wouldn’t want you to keep suffering from the endless self-doubt we survivors experience. We all did the best we could at the time. Now we have to figure out how to keep going in a way that honors our child’s best self and helps other families suffering as we did and do. I hope this essay does that for someone.  

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