For six months every Saturday morning after Rob told me about his addiction, I drove to a tiny building with blue glass windows in Forest Hill.
I’d kiss Rob and wish him a good time at his NA meeting, which started at 11am in Brixton. When he went to NA, he was often the only person in the room who still had a partner and one of the few who still had a job. Anyone who had a partner most likely met them after recovery; their previous relationships had not survived the rollercoaster of addiction.
I’d put on comfortable clothes, and carry something I could twist in my hands or hold close for comfort. Then I’d leave my home at 9.30am after a cup of tea, and I’d think about the two hours that lay ahead.
To stop myself going mad with the double life that had been pressed upon me without my permission, I realised I needed to talk to someone about what was going on.
When you’re in a marriage with an addict, at some point you will have to deal with their lying on a regular basis. But it’s not just their lies; it turns you into a liar too. It is a bitter pill, and swallow it you must.
Mal thought I was at the gym, my parents that I was busy cleaning the house. Priya knew the truth but had no way to guide me through this situation.
After desperate phone calls to my local council, I found that there was no support for the loved ones who look after addicts. We’re the ones who keep them fed, endlessly support them and defend their honour when everyone else doubts they are worth anything at all, yet no help was forthcoming.
When I made an appointment with Lambeth council to talk about this travesty, they invited me to their headquarters in Vauxhall and told me that, due to budget cuts, they had no funding to keep a support group going. ‘But you’re welcome to start your own,’ they suggested.
Great, because I had oodles of time what with working, maintaining my own sanity, lying to my family and friends, and keeping my husband in recovery. Considering how much is spent on drug addiction (including alcohol) in the UK – £15.4 billion – you’d think maybe someone would have the sense to support people like me who actually did still have jobs and were trying to help with recovery. I had to find out the hard way about the cost and reality of supporting a spouse with addiction issues.
Many phone calls later, I eventually managed to find a support group in a different borough, run by Donna, a woman whose kindness, empathy and firmness got me through the first six months.
On my first day, I felt like tracing paper. Ashamed and lost, see-through, with no language to describe how I was feeling. The daily conflicts, the yearning for our old life, my sadness for Rob and for myself.
In between going to NA and visiting his doctors, I saw how desperately he clung to redemption, and how tightly I held him so that he wouldn’t disappear down a crack. We tried to resurrect our life day by day, dinners spent in front of the TV watching zombie films, walks with Daisy. But we knew something huge had shifted.
Rob thought I didn’t notice but I knew how carefully he watched me from the corner of his eyes, wondering and waiting to see if I would leave. In disbelief that he had told me everything and I hadn’t left yet.
And I’m sure, at this point in the story, you’re thinking: How on earth could you forgive him? How could you carry on as if nothing happened?
And my answer is: Has the person you love most in the world ever said they were going to kill themselves, and, aside from the many other reasons contributing to that state of mind, one was because they didn’t want you to know who they truly were?
And if you had a chance to give that person redemption, so that they never felt so desperate as to try to gas themselves to death, are you telling me you wouldn’t take it?
Whatever punishment I could dole out, whatever judgements I laid at Rob’s feet, they would never, ever come close to what he was putting himself through. And even at that point, without all the knowledge I have now gained about addicts, drug use, suicide and mental health, I was able to understand that much.
There is such a stigma around addiction that addicts and the loved ones in their lives can rarely talk to anyone else about it.
My first support group meeting took place in a sunlit room. We sat on chairs in a circle after making tea and grabbing a croissant to eat in our laps. This was called the ‘check-in’, where you gave your name and a brief description of why you were there.
Newcomers, as in other support groups, were always given priority. I could see the circle move slowly towards me. Mothers of alcoholics, husbands of crack cocaine addicts, wives of crystal meth users. My face grew hot.
I don’t want to do this. I shouldn’t have to be here.
But if I didn’t share, the time would be wasted. And I’d have to wait another seven days before I could talk to someone else about it. So I pulled up my words that lay sunk, like stones at the bottom of a lake.
‘My husband told me last week that he was a heroin addict. He was an addict before we got married, he kept it from me. I don’t know how I am going to forgive him, but I want to. I’m so ashamed. I can’t tell my family. I love him so much but I don’t know how to get through this.’
I couldn’t stop crying. It felt like I would never stop crying, that it was coming from a tap jammed open, and it wouldn’t cease until I ran dry. Then someone handed me a tissue, and when the snot and the tears cleared, I saw the looks on their faces. It was concern but not patronising. It was ‘you’re here and that’s half the battle but we’re not going to fool you – this won’t be easy’.
But, above all, it was understanding. We were all in this room because someone we loved was an addict. And although understanding was not something we met with often outside of that room, we were there because we knew our loved ones were not terrible people; they were worth saving. They were still the people we fell in love with, the child who once had so much joy and promise, the sibling we had pillow fights with.
I learned so much about empathy and kindness in that room. But there was no denying what I saw also scared me. From what I read on drug forums, addiction was formidable. Dr Shanahan described the urge as being so strong he knew of people who had clambered over the dead bodies of people who’d overdosed to get the drugs left behind.
Some of the people in my support group had been with their partners for years. I saw how much it had defined their life – that constant swing between recovery and relapse. The fear in their eyes – the anxious people it had turned them into.
I wanted to know if anyone had succeeded in making it work; if anyone’s relationship had managed to survive. And all I found online were accounts of people dragged along the road of addiction with their partners, like their sleeves were caught in the window of a car and they were powerless to stop.
Perhaps this is testament to how much faith I had in Rob. Perhaps it is a sign of my own naivety or arrogance. But during the whole time I helped Rob through his recovery, especially in that first year, I was sure, so sure, we would be the exception to the rule.
Here’s the thing I don’t get about addiction: how, considering how widespread it is, we have managed to cock up treating it and being informed as to what it actually is.
The UK is described as the ‘addiction capital of Europe’4 and, although heroin use among the young has fallen, in the US there is something close to an epidemic. It has increased 63 per cent over the last eleven years. The number of women who use it has doubled, and there has been an increase in every demographic.5
It is telling that both countries employ a draconian approach to controlled drugs and addiction – a sentiment echoed by Dr Shanahan – and it is all too easy to draw parallels between their drug policies and ongoing failures to properly tackle a growing drug dependency crisis.
The general consensus is that drug addiction is bad, and people who are drug addicts are bad, and when someone who is a drug addict commits a crime, it is almost always framed in terms of their addiction.
Comprehending the nature of addiction is the first problem for a lot of people. Most of us have trouble understanding why someone doesn’t simply stop.
‘It’s the craving and urge to use, following the loss of the substance,’ said Dr Shanahan. ‘It’s not just an urge for chocolate or coffee. You can begin to understand it if you even look at smokers who cannot wait to get to their first, second or third cigarette. The average smoker takes seven attempts to give up cigarettes and we’re looking at a legal substance.
‘So the power of that feeling is magnified about twenty or thirty times with opiates. And therefore, if you take that from somebody, the loss to the body, the brain, the psyche, is unbearable. There is such an emptiness. They get sick as their body is withdrawing.
‘And even if you show them the damage they are causing and get them into a nice [facility], that urge remains in place. So what you really need is a patient with time and interest, and a well-supported detox. But first you’ve got to make a proper diagnosis – what is going on with the person? Are they full of shame and guilt?
‘That needs to be figured out before you go anywhere near “you’re a naughty person, you must stop using, we don’t like it”.’
Most people’s assumption about becoming an addict is that it takes either a single hit or using a drug several times, one or other of those two scenarios. But the truth is much more complex than that, and until we start having honest conversations about it at every level, it will be very difficult to reduce the number of users.
The journalist Johann Hari, who saw his career derailed by allegations of plagiarism in 2011, subsequently spent three years of his life understanding addiction and the war on drugs and has some insightful views on the subject.6 He explains that while chemical ‘hooks’ are undoubtedly part of what keeps the person using the drug, it is not necessarily the whole story. He cites patients who go in for surgery and end up on morphine, but then do not go on to become morphine addicts once they leave.
After Rob told me about his addiction, he started to open up and talked honestly about his pattern of using. I always thought the emphasis was on withdrawal but, actually, the much bigger battle came after the drug was out of his system. The problem, he said, wasn’t withdrawing, it was staying clean. It was all of those chickens come home to roost – the realisation of what he had done, the lies, the shame.
In a letter he wrote to his doctor asking for prescription drugs to get him through another relapse, he wrote:
What I’ve got myself into is a rolling, absolutely rubbish addiction, where – from the first incident, where a combination of self-isolation, arrogance, the worst bout of depression I’ve ever experienced occurred – I do a minimal amount of gear, breeze through the next 48–72 hours, until in fact I’m over the worst of the physical withdrawal.
However, it is at this point (and this is like clockwork) that the first, and probably worst, bout of clucking occurs, and while I intellectually and practically know why I need to get through to the other side without using, I become such a wreck, so quickly, and am overcome by hopelessness and all the other tricks my addiction can throw at me, that I use a tiny bit to get me through what feels like an eternity of misery every second. And so the pattern repeats itself.
Men are more likely to abuse drugs and alcohol than women. I wonder if this is due to an inability to articulate the need for help, coupled with short-term fixes to keep up appearances.
I spoke to Mr B, a well-vetted, anonymous contact who works with, for and around policy regarding mental health in the government. He said: ‘When things are difficult for men, they seek solace in behaviours that enable them to escape. Those behaviours are categorised as an addiction.
‘An addiction is where you get a buzz out of pursuing something that changes the chemistry in your brain, which makes you high or numb or makes you forget your problems. And if you have layers upon layers of things that trouble you, you will seek solace in escape. That escape becomes something you go back to in times of stress or times of “fuck it, it may be an addiction, but I enjoy it”. And what follows is shame and guilt, or “I don’t fit in”.
‘Then you get locked in this bubble of “you can’t deal with it, but you can’t confess to it”. Because you know if you confess to it, you will feel the shame of others, and the criticism and rejection of others, which you want to stop because you know that might lead you back to that addiction. So it’s a cycle.’
It may also go some way to explaining why more men kill themselves than women, as is the case in the UK. In his book Cry of Pain: Understanding Suicide and the Suicidal Mind, Prof. Williams says: ‘Alcohol and substance abuse present major risk factors for suicide . . . The prevalence of alcohol and drug abuse increases steadily from the age of fifteen until about forty-five, after which it declines.’ Interestingly, this is also roughly the main age demographic for male suicides in the UK – the biggest killer of men under forty-five.
He continues:
The number of years somebody who completes suicide has typically been abusing alcohol is between twenty and twenty-five.
This may be because, as the alcoholism progresses, it erodes those factors known to protect against suicide: first, it destroys social supports; second, it destroys intellectual function through brain damage . . . third, chronic alcoholism reduces personal control and increases helplessness. Studies show that alcohol and drug abuse are most lethal when they occur alongside depression.
This tells us that an addict’s journey is so much more complicated than we can imagine.
Like all addicts, Rob had long stopped having fun with drugs. And though the reasons why a person becomes an addict may be wide and varied, they are almost certainly taking drugs as a coping mechanism to deal with things that are too hard and too painful. And the longer the addiction goes on, the more that person becomes entrenched in drug use to cope with the shame of being an addict.
‘Most people want to get away from these drugs,’ Dr Shanahan told me, ‘and the question is: why do [these] people want to stay on them?’
He believes that harmonisation – the word used to describe methadone treatment – can work, and the danger is when you have a government that believes it cannot.
‘I think we are going to miss the people who simply cannot get off drugs and cannot stop using. There is no point pushing these people into abstinence on the basis that using methadone is simply parking them on it for life.
‘My view on that is, so what? If people are alive and safe and are given opportunities to get off it if they want to, I think it’s perfectly reasonable to offer that structure. And some people need it. The Dutch, Germans and Swiss have all found success with it.’
So why on earth does any government assume that wagging a finger and demanding absolute abstinence would work? Especially seeing as it never, ever has in the history of the world.
In fact, Hari’s theory – with which I partly agree – is that the way to tackle addiction is through human connection. Integration into society rather than penning them in a ‘them and us’ cage. Contrary to abstinence policies, evidence for the success of an integrated drugs strategy is overwhelming, showing how connecting with, rather than shunning, addicts can reduce deaths and crime.
The greatest travesty, however, is that when experts do advise the government or call for decriminalisation, they are fobbed off. In 2016, two of the major public health bodies in the UK – the Royal Society for Public Health and the Faculty of Public Health – called for the decriminalisation of drugs, saying the government’s policies had failed.7
The government denied this, and claimed that drug dependency had dropped. So this means that the machine with the power to change drugs policy is ignoring the advice of two huge, well-respected and knowledgeable bodies about a problem that affects thousands of people in the UK, not to mention the thousands of loved ones around them.
It isn’t just that the government – and this isn’t political because it is an attitude that has cut across the major national parties for decades – is not listening to the experts who know what they are talking about, but nor does it look to other countries who have successfully managed to implement decriminalisation.
‘Nearly fifteen years ago, Portugal had one of the worst drug problems in Europe, with 1 per cent of the population addicted to heroin,’ wrote Hari.
‘They had tried a drug war, and the problem just kept getting worse. So they decided to do something radically different. They resolved to decriminalise all drugs, and transfer all the money they used to spend on arresting and jailing drug addicts, and spend it instead on reconnecting them – to their own feelings, and to the wider society.’8
He has also written about Switzerland, which over ten years ago had a heroin epidemic similar to the one going on in the States at the moment. ‘Under a visionary president – Ruth Dreifuss – they decided to try an experiment. If you are a heroin addict, you are assigned to a clinic, and you are given your heroin there, for free, where you use it supervised by a doctor or nurse. You are given support to turn your life around, and find a job, and housing.
‘The result? Nobody has died of an overdose on legal heroin – literally nobody. Street crime fell significantly. The heroin epidemic ended. Most legal heroin users choose to reduce their dose and come off the program over time, because as they find work, and no longer feel stigmatised, they want to be present in their lives again.’
We use language to shame users, because we feel that they are persisting in their unhealthy lifestyle because they aren’t aware of the impact they are having on other people. That they don’t feel bad enough to stop.
How fucking laughable this is. How fucking sad that most of us, including myself, could think that this was the way to get results, rather than kindness and empathy.
Loneliness is such a huge driver of what compels someone to abuse drugs, yet instead of bothering to find this out, we and the powers that be decide that what they need is to be told clearly, in no uncertain terms, that until they fix themselves they are not allowed back into society.
Imagine the shame this causes a person. How can they ever hope to get the right kind of help, when everything is such a desperate race to wallpaper over the cracks so that they can rejoin the inner circle as quickly as possible?
For men, shame can be deadly. In Rob’s case, it was deadly. When I spoke to Jane, who used to run the male suicide prevention charity CALM, she said: ‘There is no give because there is no permission for give. Either you’re a proper man or you’re not.
‘So things like shame, embarrassment, guilt – failure to be a proper man is the ultimate disgrace for them. I often think what that must be like. Here you are, God’s chosen one. You’re supposed to do everything. Be responsible for everyone around you.’
Rob should have gone on methadone but what with him not being a child, I couldn’t force him to do it. His main reason for not wanting to go on it was because he felt it was shameful. The flipside to trying to redeem himself from feeling shameful was to try to fix it himself – something that continuously exasperated Prue and me.
This uncompromising sense of belief, the rigidity of ‘I can sort it out’, can be deadly. Prof. Williams refers to it as part of the similarity between depression and addiction.
‘The difference between people who have an addiction and don’t get into trouble with it, and people who have addiction and do get into trouble is the fixity of the belief. Say it’s a gambling addiction. Some people would say, “I’m just doing it for fun”, other people would say, “I’ve got a system and that system will work despite all the evidence to the contrary. My system will get me out of trouble.” Even if – in the case of gambling – they are in huge debt. They don’t look at the actuality of the evidence.
‘Depression is very much like that in a way, in that you have a fixed belief that “I can’t do anything about this pain, and no one else can do anything about this pain ever”. And when you understand the fixity – the way in which that belief is so stuck in place – then it enables you to understand how desperate it all is.’
Rob was the product of a middle-class family, someone who had ticked the boxes he was expected to since birth – job, house, wife – who had then been faced with the fact that he had depression, which he had tried to self-medicate since the age of fifteen.
He had to accept that this had now turned him into an addict. He also had to accept the reality of what his behaviour had done to our marriage. And then he had to enter the system to get a heavily controlled drug, the process of which was more humiliating than calling up a drug dealer.
Of course, there are some people who abuse the system. Who save it up or sell it on. But there are also a lot of people who don’t and who need the stability that a methadone or Subutex replacement therapy provides. Contrary to what anti-drugs politicians say, methadone isn’t quite the easy drugs fix they assume it to be. You don’t simply pick it up like a box of macaroons and skip merrily home.
We looked into it. You have to notify the DVLA because it affects the conditions of your driving licence. In fact, the DVLA’s attitude to it is indicative of the unbelievably cackhanded attitude to methadone treatment generally, in that it categorises it as a ‘disability’.
You can get a permit to take your methadone script on holiday but it applies only to UK customs control. It states very clearly: ‘Clients should be aware that it has no legal status outside the UK.’ So no holidays abroad, unless you like being in foreign prisons.
And you may be thinking, Oh poor widdle babies can’t go on holiday, but we were trying our hardest to keep up appearances with our families. How could we explain – with relatives in New Zealand and India – that we couldn’t go on family holidays, ever, without telling them the truth?
You also have to go on an ‘Addicts Index’, presumably so doctors can monitor who is using what drug and when. You’re told it doesn’t affect your ability to get a job, but that’s putting a lot of trust in a system that doesn’t trust you.
When you pick up your script from a chemist, they may just say loudly in front of other customers, ‘Here’s your methadone.’ If you’re agitated that day – which could be because your bus was late or you had a shit day at work – they may make you take it in front of them, so they know you aren’t hoarding it. I mean, seriously, why not make people wear a sandwich board with ‘JUNKIE’ on the front of it before they go in, you know, in the hope that their shame might put someone off using?
The irony of how people can access controlled drugs safely in the UK and US is that every step ensures they are marked out as different, outside the norms of society, when it’s more than likely that an addict started using because they didn’t feel like they fitted into the society they were expected to serve and obey.
In support groups, you find out the cost addiction exacts on a life.
We are taught from a young age that the addict is unclean; a creature to be shunned, to be treated as a horror story, as an example to all good girls and boys so that they never, ever go down that path. And you, as the spouse, fight against making your own judgements every damn day. It takes all your will not to assume that your supposedly clean partner isn’t using that extra five minutes in the bathroom to get high. Or there genuinely was traffic when they went out to the supermarket and that’s why they were late.
I wasn’t just dealing with judgement from the government. I was dealing with the devastating loneliness that comes from not being able to tell people that your loved one is an addict. Because how could I expect them to react with anything less than disgust when that would have been my reaction, if life had been different?
So, there was grief for my old life, loneliness in my new life; and all the time, every minute of every day apart from when I lay in bed with Rob and we talked and held each other, my life was fake.
No part of my life was free from the cover-up, especially work. The day after I found out Rob was an addict, I called my boss and said my husband was sick, he’d be in and out of hospital and I’d need some flexibility in my working hours. I’m fairly sure they all assumed he had cancer. I didn’t correct them.
When you’re having a bad day and your stomach is in knots because you can’t get hold of your loved one on the phone, or they call you up and ask you to transfer some money because that payment didn’t arrive on time, or the GP apparently didn’t have time to do a drugs test that morning, you cannot tell people at work the truth. You can’t explain why your colleagues need to be kinder to you on a certain morning, or why you need to work from home occasionally to make sure you don’t find your husband swinging from his bedroom door. The silence around addiction gags you. It makes you live a double life that you didn’t want in the first place.
While I tried to keep my anger from Rob, I found it impossible at times to reconcile the man I loved with the candy floss of lies he had wrapped around us both. In the search for Rob’s absolution, I asked Dr Shanahan what he thought.
‘You have to ask yourself, what is the common denominator to all of these problems? And if it’s the drug use, then that’s the link. Because there won’t be any lying if it’s about other things not related to getting to the drug.’
I thought of when Rob had lied – the night-time walks with Daisy, the odd explanations about money, the insomnia.
‘They are not untruthful and dishonest people, they just want heroin,’ said Dr Shanahan. ‘And therefore you have to ask yourself, why are we not giving it to them? Why are we making it so difficult for these people and blocking them, rather than giving them a few months or years of stability so they can stop lying? Then they can actually build a life, so they can say, “I feel better, can I try at redemption now?” ’
While his words made me feel better, they also filled me with such sadness that this was not a path we took for Rob.
I have no doubt there are sections of society – big sections – that believe addicts are a waste of space. That if indeed they are killing themselves, either through an overdose or suicide, then it’s nature’s way of thinning out a segment of the population that can’t function as well as others.
But if you’re going down that route, then let’s remove the services that save lives from cancer. Let’s unplug the ventilators and stop putting stents into people’s hearts. Let’s remove therapists, doctors, nurses – anyone who tries to heal someone who is sick or isn’t able to get by without help from other people. Let’s see how many lives that affects, whether those human beings and their families will mind.
Addicts can lie, they can let us down in the most terrible of ways. They cause chaos unlike any other. Some of them steal. They break our hearts and our trust. But we don’t question the moral ethics of someone with a physical illness as a reason for whether they can have treatment.
We don’t ask if they were naughty or nice, before deciding if they are worth saving.