Monday, August 31 marks International Overdose Awareness Day, a day dedicated to raising awareness of the risks of overdose, reducing the stigma surrounding it, and supporting the grieving friends and loved ones of overdose victims.

Drug overdose is now one of the leading causes of death in the United States. In 2019 alone, 70,980 people fatally overdosed, with 50,042 of these deaths being attributed to opioids[1]. The main culprit in over half of these deaths is fentanyl and its derivatives. Fentanyl is in the family of synthetic painkillers and is over 100 times stronger than morphine[2]. Drug dealers commonly add it to heroin to increase its potency, and even very small doses can be fatal.

In this article, I will discuss my experience as a Hostage Negotiator and explain how we can use some of the principles of Crisis Negotiation when working with Substance Use Disorder.

Because of my extensive experience in and knowledge of the mental health and addictions field, the head of the Forsyth County Georgia (a suburb of Atlanta) hostage negotiation team (or crisis intervention team as it is called) asked me to join the team as their mental health consultant in 2001. I subsequently completed the FBI’s negotiator training, trained with some of the leaders in the negotiation field, and became an internationally certified hostage negotiator. The ultimate aim of any hostage negotiation is to preserve life. One of the guiding principles of Crisis Negotiations is the principle of Zero Acceptable Losses, and this ultimate goal in a critical incident transfers directly into the addiction world. I have worked with thousands of people and still mourn every single person who has lost their life to this disease.

Terrorism is, “a major threat to society or someone who or something that uses violence, mayhem and destruction – or the threat of those– to coerce people, communities, and countries into meeting its demands. Terrorism aims to frighten, control and dominate populations.”

It is important to remember that hostages are not there voluntarily. They are being held against their will, either physically or psychologically. Hostages are necessarily traumatized by their lack of control over the life-threatening situation, and they are made to feel powerless and dependent upon their captor. Victims in hostage situations invariably suffer PTSD symptoms after being taken hostage.

Analogously, in Substance Use Disorder, the brain’s reward pathways are effectively hijacked[3]. The brain is terrorized by drugs since they hijack the dopamine system to become the addict’s  primary coping mechanism. In fact, drugs impair the user’s ability to access their frontal cortex, making it impossible to manage cravings or make good decisions. This impairment makes addicts and alcoholics appear to observers to have no morals or values because they appear unable to distinguish right from wrong. Yet, we know this is untrue. Addicts are often exceptionally sensitive, loving, loyal, and intelligent, but their addictions predictably eclipse these assets.

Families are also terrorized by their loved one’s disease and the resulting lies and broken promises. Family members often fear that they caused the addiction and helplessly watch their loved ones slowly die. To compound matters, the industry of addiction professionals has often terrorized family members as well. Many professionals in the field have pathologized family members’ and loved ones’ behaviors and reactions to a stressful, life threatening terror attack by calling them enablers. They have focused on deficiencies, not strengths.

Families are impacted, and their thinking becomes impaired as well. We know that there are mothers purchasing drugs for their addicted children because they are convinced that they are keeping their kids safer than they would be if they bought the drugs on the streets. Families need help, not because they have had bad, enabling behavior but because they have post- traumatic stress disorder, too. Their fierce love and protection of their loved one and their susceptibility to manipulation–like a victim of Stockholm syndrome–simply do not work when alcoholism or addiction is involved. This form of terrorist does not play by any rules

Addiction is a disease which unfairly carries stigma like no other[4]. This stigma is not only inflicted on the sufferer but also on the family. It is common for those uneducated about the disease of addiction and mental health disorders to associate users and their families with moral failings, deprived backgrounds, or poor self-control[5]. America’s recent opiate epidemic has shown otherwise; the many faces of overdose victims include high-achieving students, athletes, and many people with a supposedly “normal” life[6]. This means that the families of those affected by addiction should stop holding themselves hostage with blame and self-criticism. It should be acknowledged that addiction can be caused by various factors, many of which are out of the families’ control[7]. Family members and loved ones of those struggling with Substance Use Disorder must be compassionate and educate themselves about this disease in order to combat it.

We cannot let our crippling fear of addiction and feelings of hopelessness paralyze us. We would not walk away from a hostage situation and just cross our fingers that things will work out for the best. Similarly, all of us must be proactive in this war. We must be willing to share our stories, support families rather than blame them, and do more than hope for a solution. We must be willing to initiate this work with both eyes open, be prepared to fight this battle, and use every resource we have to win it. If we collectively sit back and do nothing, nothing will change.

The first step in combatting addiction is to change the way we think; we can no longer be in denial and pretend it is not happening in our communities. It is important that we educate ourselves about Substance Use Disorder and treat it with the same compassion we would treat any other disease in our society. We must educate our children on this; the more we talk openly and non-judgmentally about the subject matter, the more our kids will feel able to discuss with us any problems they may be having. Our children must know that it is not a disgrace to have Substance Use Disorder and that it is acceptable to ask for help.

Today we are in the best position we have ever been in to identify and deal with the terrorism of addiction. We now know the parts of the brain affected by addiction; we have evidence-based proven treatments and we have millions of people in sustained recovery.  We have to share the hope and treat those suffering from and impacted by addiction with the same respect we treat others suffering from diseases such as cancer, epilepsy or diabetes.

The drug naloxone, which is available without a prescription in all but one of the states, can be easily used to reverse an opiate overdose and has saved thousands of lives[8]. Having an open and honest dialogue with your loved one can be the best preventative measure one can take, so make sure you tell them that help is available when they want it.

For those of us dealing with the pain of losing a loved one to this disease, it is equally important to speak out and to seek help with this. The stigma of addiction can make this tragic loss seem very isolating, but the truth is that there are tens, if not hundreds, of thousands of families in America who have suffered a similar tragedy. There are mutual support groups across the country, and there are many different therapeutic avenues one can explore to process this grief.

The most salient point in this process is to note that it is not your fault. By speaking out, you can reduce the stigma of addiction and may help another family prevent this loss. In the fight against addiction, we can all become life-saving hostage negotiators. We must fight this together with the guiding principle of Zero Acceptable Losses.

For more information, contact Heather R. Hayes & Associates – call 800-335-0316 or email info@heatherhayes.com today.

Sources:

[1] “Products – Vital Statistics Rapid Release – Provisional Drug Overdose Data”. Cdc.Gov, 2020, https://www.cdc.gov/nchs/nvss/vsrr/drug-overdose-data.htm.
[2] “Fentanyl”. Dea.Gov, 2020, https://www.dea.gov/factsheets/fentanyl.
[3] Volkow, N., Li, T. The neuroscience of addiction. Nat Neurosci 8, 1429–1430 (2005). https://doi.org/10.1038/nn1105-1429.
[4] Fraser, Suzanne et al. “Addiction Stigma And The Biopolitics Of Liberal Modernity: A Qualitative Analysis”. International Journal Of Drug Policy, vol 44, 2017, pp. 192-201. Elsevier BV, doi:10.1016/j.drugpo.2017.02.005. Accessed 24 Aug 2020.
[5] Movahedi, Siamak. “The Drug Addict And Addiction”. Urban Life, vol 7, no. 1, 1978, pp. 45-66. SAGE Publications, doi:10.1177/089124167800700103. Accessed 24 Aug 2020.
[6] Quinones, Sam. Dreamland. 1st ed., Bloomsbury Publishing USA, 2015.
[7]Erickson, Carlton K., and Richard E. Wilcox. “Neurobiological Causes Of Addiction”. Journal Of Social Work Practice In The Addictions, vol 1, no. 3, 2001, pp. 7-22. Informa UK Limited, doi:10.1300/j160v01n03_02. Accessed 24 Aug 2020.
[8] Morgan, Jody, and Alison L Jones. “The Role Of Naloxone In The Opioid Crisis”. Toxicology Communications, vol 2, no. 1, 2018, pp. 15-18. Informa UK Limited, doi:10.1080/24734306.2018.1458464. Accessed 24 Aug 2020.