When failing to treat a drug addict becomes a breach of human rights
This paper is adapted from a speech given by the writer at the 2019 Auckland Writers Festival.
In 2015 I took my adult son against his will to a city in Sumatra, Indonesia, took control of his life and forced him to come clean from drugs. Some may think that I violated his rights. They can look at the world that way. I don’t. There’s more to the story than this, of course.
My son, Hemi, was a chronic IV meth user. When I found him in a small town in north Brisbane, Australia his comfy little bachelor’s pad was unrecognisable. Holes were punched in the walls and furniture broken due to meth rages, the cupboards were bare, the kitchen stank from unwashed cookware and rubbish, yellow plastic containers with used needles littered the house. Mounds of clothes lay on every surface and the bathroom was barely usable. Tragic zombie-like men and women were lying on couches and floors or were babbling mindlessly and chain-smoking. My son was also barely recognisable; a vacant, toothless face, needle ‘track’ marks up in his arm. Gaunt and pale. He could barely talk and when he did, I could make little sense of what he said. He had lost the ability to function in any meaningful way beyond the crude basics of life: wash, dress, eat, get money, find and use drugs.
Meth is a potent drug that provides a powerful sense of euphoria and that destroys the pleasure pathways in the brain. It creates a false sense of happiness, overconfidence, and hyperactivity. It can cause memory loss, aggression, psychotic behaviour and heart and brain damage.
Hemi has lost many of his friends to this drug.
Although I had experience working with and teaching addicts, and a social work degree, I had tried and failed for 10 or so years to help my son deal with his addictions and get his life on track. On the good days I gently confronted him, I didn’t enable him to keep using by giving him money and goods that he could sell to buy drugs. I set boundaries. I accepted that he may always be an addict and that he might die from it. On the bad days, I nagged, threatened and pleaded. On the worst days, I yelled and sobbed. Once, when he was hospitalised after a psychotic episode, Hemi’s father and I managed to get him to a rehab. He lasted a few weeks, and within a few months, he was back to his drug life. As his drug use worsened my ability to influence him dissipated and I eventually walked away. However, I still loved him deeply and became consumed with why my handsome, sporty, witty and intelligent son had squandered his gifts and become such an ugly waste of space. I started researching and writing.
While I was writing what became Dancing on a Razor’s Edge[i] I was contacted by Lily, a woman saying she was Hemi’s girlfriend. His druggie friends had become seriously concerned about his health so tracked me down on Facebook. I grabbed this chance to get back into his life and to work out what to do.
I sought help from various addiction and social services, and the police and found most of them to be woefully inadequate. I was told, repeatedly — and harshly at times — that I needed to stand back and wait for Hemi to become ready for treatment and to ask for help, that he needed to reach ‘rock bottom’. Eventually, they said, he’d come to the point of realisation that his choice of lifestyle was not working. It was his fault and his responsibility. I had to get out of the way.
But he’d been at ‘rock bottom’ for years and was so drug-addled that he couldn’t ask for help. It was clear he would die if someone didn’t do something. And the only someone seemed to be me.
I spent a month in my son’s chaotic meth house to get into his world, understand the situation he and his friends were living in — and formulate a plan to get him into treatment. First, I had to mentally prepare myself. Rescuing a drowning man is risky — but saving one who didn’t want to be saved is a different matter. I had to toughen up. To become desensitised to the horror of his situation — to not be frightened of the drugs, the needles and the heart-breaking sight of my son in psychosis. I had to take care of me but make my son’s needs the priority. This is not about me, I would say.
My first attempt to coerce him into treatment, Plan A, was a fail. To get into rehab an addict must phone it themselves. But Hemi was in no state to do this. I had to get him drug-free so that he could make the calls.
I was living in Indonesia but had a consultancy assignment in the Pacific. I had a free week so flew from Jakarta to Brisbane with my husband Opan. We found and uplifted Hemi and Lily and drove three or so hours to a motel in north Queensland. After three days I managed to get Hemi and Lily to agree to make some calls. Both managed to get on waiting lists but they were told a placement would take weeks or months. In the meantime, I reasoned, Hemi could go to a detox facility and from there directly into a treatment program. I rang a detox centre. They asked “How long have you had him with you? About a week I said. “Oh well, then he’s already detoxed.”
This meant they wouldn’t take him, and I had no choice but to deliver Hemi and Lily back to their unit and hope, beyond all likelihood, that they would stay clean and continue to make weekly calls to rehabs.
A few weeks later I returned to total chaos, but ready to enact Plan B. This was to use an upcoming court appearance as an opportunity to get Hemi diverted into a drug program. He was facing a prison term for a litany of minor crimes and unpaid fines resulting from his addiction. Failing this, I would try to get him to a rehab I’d found, in Indonesia. I needed a support crew. None of the addiction services that I’d tracked down was going to help — so it would be addicts, and mothers and fathers of addicts, and my friends and family that would keep my son safe, sheltered, fed, and help me get him to rehab or bring him home.
None of the legal aid lawyers was available or willing to support my rescue mission, but I found a private lawyer who was. There was no court diversion program but, if we could get him booked into a rehab, then the lawyer would talk to the judge about suspending Hemi’s sentence and, if necessary, bypass parole restrictions allowing him to leave the country. After painstaking and multiple visits and calls to rehabs throughout Australia and New Zealand, I was unable to secure a placement for him. As a backup I had, though, gained a place in an Indonesian rehab. This required getting a passport for Hemi without arousing Lily’s suspicions. And to get out of the country leaving significant unpaid fines. And make it on to the plane without incident.
After two months in Jakarta, my son was offered a placement in a rehab in Queensland and he returned to Australia. A month later he was kicked out because he got angry when Lily failed to turn up to a planned visit. He immediately overdosed and was again hospitalised. I returned to Australia to coax him back to Indonesia but was unable to do so. He again went into an agonising decline and despite the best efforts of his friends to encourage him to ‘go with your mum’ he refused. A second court appearance gave me another opportunity to take him back to Indonesia and back to rehab, but he was asked to leave there too. They didn’t feel he was sufficiently engaged with the program.
By now I was working between Sumatra and Jakarta managing a climate change mitigation program. At the same time, I had to fashion a recovery program for my son. Given three rehabs, counselling, prison, NA and a psychiatrist had proven unhelpful or ineffective for him in the past, then me giving it a shot surely couldn’t hurt. In fact, I was the best-placed person to get him home straight. Why? Because I knew and loved my son and I wasn’t going to give up on him as others had. I continued my research, but more importantly now, I listened to my intuition.
Around the time that I was ‘home-rehabbing’ Hemi, one of my best mates in Jakarta, Frank in the book, died from his alcoholism. He was 43. Unlike my son, he worked (as an English-language teacher) and he functioned, even while his daily vodka intake rose to two bottles (we knew this from reports from his cleaner) right up to the point that his employers hospitalised him because his yellow eyes and skin were frightening his students.
Doug Sellman, Director of the National Addiction Centre in New Zealand says that compulsive drug-seeking is initiated outside of consciousness. That is, a primitive part of the brain decides before the thinking conscious brain has had a chance to weigh things up.[ii] This challenges the idea that an addict has the free will to choose to use — or to stop. A police officer told me that meth addicts lose control of their mental and later bodily functions. Frank was so deeply in denial he couldn’t see that alcohol was destroying his body. Given all of this, how can severe addicts be expected to make phone calls every Wednesday at 10.30 a.m. until they can get a place in rehab?
Occasionally someone can get to treatment alone — most need to be led, but we need to accept that some need to be forced.
Why was Frank left to die? Why did no-one intervene to save my son’s life?
It made absolute sense to me that the most important thing to do was to force a separation between Hemi and his drugs? To get him lucid and facing in the right direction.
I have no difficulty with the idea of involuntary treatment. Neither does the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment.[iii] It says: “As severe addicts only enter treatment when coerced, and, as addiction is often a precursor to crime and that treatment generally reduces drug-related crime while there is mounting evidence that imprisonment doesn’t — there is an increasing willingness to force substance-use offenders into treatment.” This aligns with research done by the Australian National Council on Drugs[iv] which found that coercion may be effective depending on the type and timing of it and factors such as personality and life experiences. New Zealand provides for involuntary treatment, but under criteria that would exclude Hemi and Frank. Western Australia has adopted an involuntary treatment plan including short-term safe places for compulsory critical intervention.
Involuntary treatment is something all of us should agree on. It is reprehensibly inhumane to leave a seriously ill person with a cruel and debilitating affliction to suffer and die. Would we ask an accident victim to ask for treatment, or to go through hoops and hurdles to ‘prove’ they were ready for treatment before we uplifted them? Some addicts are also parents and in neglecting them we are also neglecting their children. We’re setting these kids up for a life of struggle with learning and behaviour.
We need to be stepping in, in many cases — not stepping back.
The major reason Hemi and Frank were left to die or become incompetent is that much of society believes they brought on their condition themselves. They made 'poor choices' and should suffer for them and be punished for them. But addiction is not a choice. Drugs or alcohol (or other mood-altering substance or behaviours) start as a pathway out of pain but end up entrenching it.
The idea of addiction as a moral failing permeates our popular culture as fear of, and a disdain for, addicts. I recently watched a family movie where the alcoholic father’s drinking had got to the point that he was violent towards his wife and he was neglecting his son. Everyone — quite rightly — had sympathy for the mother and for the child. But no-one had sympathy for the father. He was clearly in pain and wracked with guilt, yet he was vilified. What if we turned this around and saw this man in need of care and attention? We would then potentially get good outcomes for the whole family.
The idea of addiction as a moral failing or crime also permeates our treatment systems. Rehabs are often punitive, focusing on addressing the behaviour of the addict and not the reason that the person becomes an addict. Addicts can be repulsive, dishonest, antisocial and childish — but these are only symptoms or indicators of illness. My lovely friend Frank had been sexually abused by a family member as a child; my son had a learning deficit that frustrated his efforts to solve problems, and he witnessed violence between his parents as a toddler. Addiction is a biopsychological condition. It functions as a coping mechanism to deal with a raft of traumas and dysfunctions that often occur in childhood. Missing fathers, bullying, mental illness, anxiety, sexual abuse, pain, fear, loss, loneliness, abandonment, neglect.
It’s no wonder that most people relapse after rehab — often numerous times — as their core problems are not addressed.
He Ara Oranga: Report of the New Zealand Government Inquiry into Mental Health and Addiction 2019 states, among other good things, that addiction should be viewed as a health and social issue requiring care and support. It also recommends replacing criminal sanctions for the possession for personal use of controlled drugs with civil responses, such as fines or treatment programs. What it doesn’t say is that we are dealing with a humanitarian crisis.
There are huge gaps in treatment services in New Zealand and Australia. Highly educated and committed support workers in the addiction field tell me addiction is seen as ‘the poor cousin of health’, they are under-resourced and overwhelmed; burnout and turnover are high. Treatment is difficult to access, methods often questionable, and outcomes poor or unknown.
The most glaring lack is for early or pre-treatment support — currently provided by family and friends or by no-one — where a severe addict can be taken involuntarily or go voluntarily when and where help is needed. In a low-key way, I and others have been trialling ‘safe spaces’ under a broader Home Straight Initiative that includes peer mentoring for parents and addicts. These spaces are in private homes but could be anywhere — hospitals, prisons, or as adjuncts to rehabs. Even workplaces. They could also be viewed as respites from the chaos of addiction. They are safe in that there is no judgment, criticism, no drugs, no chaos, no pressure and few rules. The are no guarantees — they are just a starting point for change and can form a bridge to other services and to a broader solution.
For years I was angry at my son for his seeming bad choices, his rudeness, his lack of motivation. I nagged him, was ashamed of him, embarrassed by him. Everything changed for me in that meth house in 2015. I realised he was lost, in pain and he needed to be brought home. It was me that became ashamed of the way I had viewed and treated him. While he initially railed against me, over time he accepted the situation and came to understand my rationale in removing him from his drug life.
He had been kicked out of schools and rehab and believed he’d been kicked out of home. I was determined not to let that happen again. I created a safe space for him. If he was going to come out of the hell hole he was in, and stay out, he could not be greeted with tuts-tuts and ‘Look what you’ve done to your father and me?’ He needed to be welcomed with open arms and loved back to life.
I forced him to nourish his body and restore his drug-damaged brain. I forced him to get his teeth repaired. I forced him to live his childhood dream of becoming a professional fighter. I forced him to grow up and deal with his pain. And what does he think of me for denying his rights?
When Dancing on a Razor’s Edge was published, he put a picture of it on his Facebook page with this message: ‘My mother has been working on this book for some years now …. and if it wasn’t for the lengths of effort she went to over these last few years I would most likely not be alive today (the way I was going). Although I avoided her at all costs during many years on the shit … she NEVER gave up on me! I LOVE YOU MUM!
[i] Published by The Cuba Press, Wellington, New Zealand, 2018
[ii] Sellman, D: The 10 Most Important Things to Know about Addiction, Society for the Study of Addiction, 2010
[iii] ‘Report of the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment’, 2003.
[iv] From Pritchard E, Mugavin J and A Swan. ‘Compulsory treatment in Australia. A discussion paper on the compulsory treatment of individuals dependent on alcohol and/or other drugs’. Australian National Council on Drugs, 2007.