For parents of the addicted, an endless cycle of hope and despair

We don’t get many chances to share a mother’s torment about an addicted son being released from prison, the hope that things will turn out well, the crushing disappointment, and the fear of what may come next.

So it’s been easy to root for Char Briner, Minnesota’s Deputy Education Commissioner, who has shared her story over the last few years.

The drugs came before the run-in with the law, the weapons charge that sent Nick Briner to prison. Her story is all about the drugs. He’s been in an out of treatment since he was 14.

“It’s the battle between living in limbo and living fully,” she wrote more than a year ago, after Nick had gotten out of prison and disappeared.

He was apprehended, sent back to prison, and released again, and things seemed to be going well, what with rehab and a new job.

In her first Medium post since last September, however, she tells us he’s back in county jail on a number of offenses, the result of a lag in seasonal work, and the opportunity to get in trouble.

How can I explain the anxiety of not knowing where your child is? No matter how many times I’ve gone down this road or how mentally prepared I am for the possibility, it still sits heavy as stone on my heart and mind. Like every time he has disappeared into the wilderness of addiction, I am left to imagine the worst and hope for the best. It’s an odd, almost surreal truth that there is equal parts heartbreak and relief at his relatively quick arrest, because I know the alternative outcome of his frenzied flight could just as likely have been his death.

According to the National Institute on Drug Abuse, addiction is a chronic and relapsing brain disease in which drug use becomes involuntary despite its negative consequences. I know this to be true. I know that for Nick — at least so far — the pull of drugs and gambling and street hustle are far stronger than the positive effects of sobriety. Try as he might to escape it, he hasn’t been able to stop chasing the hungry ghosts that simultaneously beckon and torture him. I don’t know if that will always be true, but for now, it is undeniable.

The “hungry ghosts” are consuming a generation or two all across America.

We can’t imprison our way out of it, the experts say. But we keep doing it because we either don’t know what else to do, or are unwilling to try.

Should those who relapse be back in prison is a case now before the Massachusetts Supreme Judicial Court, the New York Times reports today, documenting the case of Julie Eldred, who snorted her favorite drug — fentanyl — 11 days after her probation began.

Remaining drug-free is an almost universal requirement of probation, the Times notes.

The craving for drugs leads people to criminality. But does the drug use itself merit criminal sanctions?

Is addiction a brain disease that interferes with one’s capacity to abstain? Or a condition, rather than a disease, that is responsive to penalties and rewards, the Times says in describing the question before the SJC.

Having misused drugs since she was 15 years old, Ms. [Julie] Eldred argues that she was incapable of stopping abruptly. A brief signed by addiction medicine experts and policymakers supports her.

In it, they state that addiction is “a primary, chronic disease of brain reward, motivation, memory and related circuitry.” Someone severely afflicted needs the drugs not for a pleasurable high, but to maintain a new normal and stave off withdrawal. The brain becomes so compromised, they say, that relapse is not only involuntary but to be expected on the stop-start journey to recovery.

Relapse, therefore, is not an indication that an addicted person is willfully defying a court’s order, said Lisa Newman-Polk, Ms. Eldred’s lawyer, a former social worker, but “a symptom of the disease and a signal that the addiction is active.”

Instead of jailing Ms. Eldred, a judge could give treatment more time or alter it, she said during oral argument in October.

In a brief supporting the prosecution, psychiatrists, psychologists and legal scholars assert that the brain-disease model is contested. Changes in brain structure from drugs do not necessarily translate into an inability to resist them, they said. With carrot-stick prompts, many addicted people can choose to abstain.

And, prosecutors said, two such prompts include an expunged record for completing probation or, for relapse, jail.

A brief submitted by the National Association of Drug Court Professionals on behalf of 3,400 drug courts noted that the success of these programs depends on a judge being able to apply graduated sanctions, to propel a defendant through treatment.

Eldred’s story is shared by tens or hundreds of thousands across America. Hooked by high school, dominated by opiates, a period of rehab and a stretch of hope. But then, you meet an old acquaintance.

Hawaii’s approach was hailed as a national model. But recent studies show it doesn’t really make a difference either.

Kelly Mitchell of the University of Minnesota Law School’s Robina Institute for Criminal Law and Criminal Justice, suggested a middle-ground solution. A judge could order the offender to be evaluated for substance use disorder and to follow treatment recommendations, she said. A violation, she said, would be for “failing to get the evaluation and to attend treatment, rather than failing to remain drug-free.”

For Julie Eldred, the requirement to stay drug-free was a disincentive for recovery. “Knowing that a relapse leads to a probation violation made it harder for me to talk about my struggles, for fear of being locked up,” she said.

In the meantime, jails and prisons fill with the addicted, and the country’s homes fill with parents who can only hold their breath and try not to give up on their children.

Archive: A father’s story: How a ‘really good kid’ died of a heroin overdose (NewsCut)