Brooke sits beside her mom on the couch at Rea of Hope’s New Life Apartments. Rea of Hope is an addiction and recovery center for women struggling with alcohol or drug abuse.
“When I was 15, I had my wisdom teeth pulled out, and this was right before the beginning of the oxycontin epidemic, so they gave me oxycontin,” she said. “And it was just a sensation I can’t explain – it changed something in my mind. And after that it was kind of a slow process for year or two and then it was full-blown. I had to have it.”
Brooke is in recovery. So is her mom, who we’ll call Martha.
“I was dealing with losing my daughter to addiction and then I lost her father – he had an overdose,” said Martha. “So I was struggling to get through that and I started drinking. And it made me feel better in the beginning, but you know relationships, family relationships, all the dynamics changed because of the drinking. And I was aware that it was happening, but on the other hand it just made me feel better.”
Two years after Brooke was first prescribed oxycontin, she tried heroin for the first time. She was 17.
“I knew she was struggling at that point and I truly tried to help her,” said Martha. “But I was just enabling her addiction. And so therefore things so spiralled out of control so fast, drinking really gave me some sort of relief at the time.”
As family relationships began to strain and break under the weight of addiction, Brooke and her mom said they became a kind of team.
“It was like we would enable each other toward the end,” said Brooke. “We were both aware, at this point it was no secret, but it was like ‘well you’ve got this and I’ve got that so you know and there’s really similar.’ It was like this bond we had, this really sick bond, we would defend each other to other people.”
In a way, this isn’t surprising.
“Addiction clusters in families,” explained Laura Jean Bierut, a psychiatrist at the Washington University School of Medicine in St. Louis, MO, who studies familial clustering of psychiatric illness and addiction.
“And so the question is, why is it clustering in families? Is it the environment of the families, or is it the biology of families, the genetic predisposition?”
In a nutshell, it’s both. What has dramatically changed in recent years is the introduction of widely available opioids.
“We know that our genes actually haven’t changed over the last 50 years, but we have this new opioid epidemic and this opioid epidemic is because of environmental changes,” said Bierut. “This recent drive to prescribe medications over the past 15 years.”
When we see addiction clustering in families – Brooke’s biological dad died of a heroin overdose, which later became her drug of choice while her mom struggled with alcoholism – we’re seeing a lethal combination of genetic susceptibility to addiction, fed by today’s environmental upswing of prescriptions.
“Even though there is this biological predisposition running in families, we also need to think of the family as a unit of environment,” said Bierut. “It is very difficult for someone to become abstinent and enter recovery when other family members are using substances.”
Remember what Brooke said?
“It was like we would enable each other toward the end.”
But when Brooke got into her latest round of treatment – there had been several – something shifted in not only her, but in her mom.
“She would visit me – she was still drinking – and when I got to Rea of Hope, she started coming to meetings with me,” said Brooke. “And she then continued her journey into her sobriety.”
“So we really do need to be looking at families when we are treating addiction and to know if there is multi-generational substance use in that family to really try and get everyone in that family into treatment and to encourage abstinence among all family members,” said Bierut.
But ultimately recovery is a personal decision. Brooke and her mom say their sobriety is not dependent on the other’s decision not to use. If one of them relapses, they will still individually pursue recovery. In other families, though, recovery may mean cutting ties with those still using so that the unit of environment, so to speak, shifts in a more positive direction.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health, Charleston Area Medical Center and WVU Medicine.