Expert: Jacqui - 2/2/2009

Question
QUESTION: My son (age 23) has had a lot of issues and was diagnosed with leukemia last year. He has been to rehabs (because they won't transplant an addict), and although he isn't doing heroin or shooting meth anymore, his drinking is still a problem and along with the drugs (morphine and oxycodone) they give him in the hospital. He says he always asks for interveinous (sp) but if they give him a pain pill, he dilutes it with water and shoots it into his own IV. Obviously I have a lot of questions.

ANSWER: Hi nan,

I am absolutely appalled if it is true that they won't treat your son because of his drug use.  His drug use didn't cause the leukemia and it is ridiculous that, just because he decided to use drugs that aren't legal, as opposed to the drugs that are (alcohol), that he is denied his human rights to medical treatment.  But I guess you are in America and the health system there is a disaster.  

Anyway, it seems that your message cut off because you said you have a lot of questions but haven't actually written them in so I don't know what you would specifically like to know.  If you are wondering about injecting pills I can provide information about how people can minimise the harms associated with this (there are safer ways to do it).  

Let me know what you would like to know.  I am, however, about to finish work and close the computer down (it is late afternoon in Melbourne, Australia where I am), so I may not get your message until tomorrow morning.

Take care, stay safe and I look forward to hearing from you again

Jacqui

---------- FOLLOW-UP ----------

QUESTION: Yes..we were all appalled that Stanford refused treatment last year because he was in the best physical condition of his life, and since then he's gone out of remission and his body is showing the effects of the second round of chemo. I stumbled on a thread you participated in and was impressed with your "reduce the harm" approach. I...being Alex's Mom and loving him more than anything in the world...don't believe that his addiction is as much a physical one as an emotional one. He has always been very timid and shy and a people pleaser but it's always been hard for him to fit in. I'm sure that's why he started seriously abusing drugs in the first place. But then it seemed like he was moving on...he was going to college, was starting to break away from the ties his Dad had on him and I thought he was through that rebellious stage and on his way to his own life.
But then he was diagnosed with Hodgkins 3 years ago and it was like he rebelled against everything all over again....only even more distructively.
I guess I'm questioning what I should do about things myself. Of course rehab tells me to let go, and of course my Motherly instincts tell me to hold tight and get him through the leukemia and then let go...but he seems to be fighting against me and his Dad and even the Drs and everyone else who's trying to help him. And the sneaking and lying and stealing and everything else has just got me feeling like I can't help him if he's not willing to accept what's going on and help us all get him well again.

Answer
Hi Nan,

I am really saddened by your situation.  I understand that there might be some situations where the are concerns about treating someone - ie: a heavy drinker getting a liver transplant and having no plans to stop drinking, etc - but I think that this situation is really appalling.  I know I do get a bit carried away with US-Health System Bashing, but in Australia this wouldn't be the case.  They even took away the provision that people wanting treatment for hepatitis C had to stop using, so people who continue to inject can now get treated.  I guess the fact that the Leukemia doesn't have anything to do with the drug use makes me think that this really is a human rights issue.  

I am glad that you are interested in harm reduction.  I don't want to come away sounding like a zealot, but I do find it is the most sensible and humanistic approach to drug use.  Many people use drugs, most of them legal like alcohol, and some people have problems and some don't.  Where I work we provide clean injecting equipment to people so that they don't share needles and get HIV, which isn't just good for the injecting drug users, but also good for the health of the community, because injecting drug users don't just have sex with other injecting drug users, so even if people don't care about the drug users, reducing harms is good for everyone.

It sounds like you are in a very tough situation.  It sounds like your son has gone through a lot and had lots of ups and downs, like most people with drug problems go through.  I can imagine that even if he had been doing well for a long time, the shock of hearing that he had cancer could potentially make him want to just say "f**k it! I want to get wasted".  Unfortunately, the fact that he isn't being treated will, in my opinion, only reiterate that he is marginalised from society and in some ways could make him want to keep using - ie: "society doesn't care about me, why should I bother trying?"

What is really important though is how you are coping with all of this.  I guess I can't tell you which way you should go (ie: cut him off, or stay supporting him), although I am suprised that the 'rehabs' say "let go".  This is a decision that you must come to yourself.  However, there are a couple of things that I would suggest -

- finding someone impartial for you to talk to (and not someone who is going to tell you to "let go" - counsellors shouldn't tell you what to do, but help you decide).  This might be a counsellor, family thearpist, peer supporter, priest, minister, etc.  It is often difficult to make decisions without having someone there to sort it all out for you.  Have you ever spoken to someone?  

- setting some ground rules.  If it is possible to speak to your son it would be great for you to be able to tell him that a) you still love him (as it sounds like he might have some doubts about loving himself, I think that this will be important), but b) you find it hard when he is doing things like stealing and lying to you so when he does these things, you won't be able to support him and you will have to ask him to leave.  This may have the effect of reinforcing positive behaviour - although it will take time.  

Nan, keep up the good work.  You are a strong and supportive woman and I wish you all the best.  If there is any more information I can provide, please don't hesitate to let me know.

Kindest regards,

Jacqui