Often the narrative surrounding drug addiction is centered upon the trials and tribulations of the consumer of the drug, whose temporary well-being and sustenance are dependent on the existence of a set of practices or substances that are damaging to health in the long run.
The derelict state of mental health and addiction care is universal. Whereas drugs are embroiled in widespread street culture, the high-end rehab centres and counselling are within the reach of very few. Turning life around not only depends on snapping out of denial and seeking help but also on the financial ability to invest in the long journey of healing, and even so there is no guarantee of return.
In what may seem like a dead end with relentless cycles of booms and busts, where progress is made only to end in another episode of breakdown, overdose, hospital visits, and frantic loved ones, we forget about the secondary trauma of addiction experienced by family members.
These are the parents, siblings, children, partners who are exposed to the bouts of addictive habits of their loved ones. Watching a loved one suffer and decimate without being able to help and living with a constant fear of loss can be as paralyzing and debilitating as having post-traumatic stress disorder.
We usually hear about secondary trauma experienced by doctors, physicians, nurses, social workers -- people working with traumatized patients and clients. However, it is mostly family members and friends who assume the role of the primary caregiver to loved ones who experience trauma and pain from addiction.
Therefore, we need to expand the definitional limits of secondary trauma to include family members who experience pain in the process of caring for victims of addiction and trauma.
Addiction is more common than we think. It has many facets, reasons, and phases. It may start with a puff of cigarette smoke led by a simple adolescent curiosity in a society that glamourizes smoking but blames individuals who die from lung cancer, or sometimes it may start with a daft display of entering adulthood by smoking weed at a party.
But addiction may also be a way to escape one’s reality, trauma, and pain. When we imagine addiction, we see someone high and sweating in a hot room shooting up or injecting heroin and crashing on the pile of rolls and ashes on the floor, shuddering with the last bit of life that they have left. We let our imaginations run wild when it comes to people and illnesses that we cannot fully comprehend.
But all forms of addiction do not involve class-A drugs or transactions in the dark web and alleys. Some of these decisions and trades are made at doctors’ offices, clinics, and pharmacy counters when we obtain prescription pain relieving medications such as anti-depressants, or self-medications as a form of secondary addiction replacing the first source of addiction.
Withdrawal symptoms from many of these classes of medications are extremely severe and can lead to death. Some studies show that it is harder to stop smoking than to stop doing cocaine. Despite being more socially acceptable, highly advertised, and supported, tobacco and alcohol are the two leading causes of addiction and addiction related deaths.
There can be many wars on drugs but the most common sources of addiction, such as the cigarette, are legal. Criminalizing certain drugs and concurrently leaving out others from the “criminal” category as a policy tool to address addiction is questionable.
When a family member struggles through addiction and failed attempts at withdrawing, the addiction experience becomes collective. Being a constant bystander to pain has its invisible effects on family members’ mental health, something that is easily overlooked.
Certain forms of substance abuse are stigmatized which even hinders caregivers and families from talking about them or seeking help. Stefano Bloch, an urban geographer, who writes about the street and graffiti subculture in the “gang hoods” of Los Angeles, talks about how he felt guilty to leave his mother alone as he was the one who would have to call the police or the hospital if his mother passed out in the bathroom or on the couch from shooting up heroin.
How many times do family members come close to a loved one’s death, knocking and breaking doors, growing numb and cold with paranoia, shaking overdosed sons or daughters out of sleep, cleaning up broken plates and glasses, being forced to pay for the same drug that gradually squeezes life out of their brothers and sisters, all the while hiding it from society? The feeling of failure and guilt is never-ending.
Certain forms of addiction are so common in working-class families that we usually leave them out of the national addiction narrative. We do not talk about the drunken rickshaw puller or construction worker, or a drug dependent member of a poor family physically abusing caregivers and income providers, and stealing rent or grocery money to gamble, socialize, and abuse substances as a mode of recreation.
If we want to understand the dynamics around youth drug abuse, we need to examine the broader cross-class drug culture and consumption decisions. Where the line between consumption and abuse of substances blurs, there is no active decision making, by this point the consumer becomes an addict.
What is intriguing about substance use is that there is no one determinant that explains addiction behaviour. For instance, a study by researchers at the University of Michigan -- on socioeconomic status and substance use habits among young adults -- show that lower family socioeconomic status is associated with higher instances of smoking.
The same study found that alcohol and marijuana uses are correlated with higher family socioeconomic status, two contrary findings for different types of drugs. Adolescents from affluent families have better access to opportunities but that might not necessarily derail them from substance abuse.
Having access to resources to manage withdrawal symptoms gives certain youth a better chance to turn their lives around. In studies focusing on drug consumption practices in Bangladeshi youth, friend circles are commonly cited as the breeding ground for pushing drugs. If that is the case, then how do we explain the choices made by youth who actively decide not to pursue drugs regardless of how popular it is?
Families are lost in this unyielding matrix of drugs, pain, and powerlessness. The reality and the years of life lost behind closed doors are excruciating to bear for many, pushing people to pop pills as an alternative to having a conversation; sometimes we knock on those doors too late.
Criminalizing and stigmatizing victims of addiction or their families further demoralize any slim efforts that they might make to break from the vicious cycle. In the old times our grandparents chewed their tobacco with betel leaves, their lips turned red as the mix crushed in their mouth. Drugs have always been around, but the dire pang of modern addiction is different, an epidemic that our society has failed to address.
Sarzah Yeasmin is a Boston-based Bangladeshi writer and graduate student studying education policy at Harvard University. She is the program coordinator for the university’s innovations in government program.
