Introduction

A different direction, this is the message my dear friend Deborah McCloskey is clearly portraying throughout her engaging story. Deborah's untiring work to guide those in methadone treatment centers toward wise choices, developing self-esteem, and to search for new and different directions for their lives is obviously heroic.

Statistics tell us that the current need for addiction counselors, as well as rehabilitation and recovery clinics, far outweigh the current population need. In a paper prepared for the national Substance Abuse & Mental Health Services Administration (SAMHSA) titled “Substance Abuse Treatment Workforce Environmental Scan” it is noted that:

Obviously, the need for addiction and recovery counselors is paramount to the task of guiding those addicted to drugs (including methadone) and alcohol toward that different direction which can lead to a healthy sober future. Statistics from SAMHSA's National Survey on Drug Use & Health (2007) show there is an estimated 22.3 million persons over the age of twelve with substance dependence or abuse. This is almost ten percent of our national population. Although about 2.4 million people received treatment at a specialty facility in 2007, millions of others addicted to drugs and/or alcohol reported they needed treatment but did not receive help for their problem. More specifically, there has been no perceived change in the use of heroin over the last several years, 2002 to 2006.

Heroin is a chemical derived from one of nature's most beautiful flowers, the poppy. The specific poppy plant which yields opiates is the papaver somniferous. The production of opium and heroin from these lovely flowers was deemed illegal in the United States in 1920. However, stopping the underground drug market from smuggling the substance into our nation seems impossible. Heroin comes onto our streets from many countries including the Czech Republic, Mexico, Canada, Colombia, the Orient, and Southeast Asia. It is smuggled by air, sea, land, and even the mail.

Although heroin use may not hold the highest number of abusers over other forms of addictive substances—more than 600,000 in the United States—the social and health effects of heroin on our society is overwhelming. Family structures are compromised as jails are filled with addicted parents; education is impeded while children follow their family's substance abuse behaviors; and, our criminal justice, as well as, health and social services systems are all impacted negatively. Americans can now claim that almost half of us know someone with a substance abuse problem. I echo Deborah's puzzling question of “What's really going on in our society that we cannot deliver a workable and compassionate recovery program for our addicted population?”

Some feel methadone, a synthetic opiate, to be the best way to help those addicted to heroin become free of it. Others believe using an alternate addictive substance to achieve this freedom is a defeating measure in itself. Also, there is a common assumption surrounding the use of methadone that once on methadone treatment always on methadone treatment. In his acclaimed book Recovery Options, Dr. Joseph Volpicelli writes:

Despite methadone's obvious role in helping some heroin addicts, it does have addictive properties and, therefore, is also a risk for its user, its potential street market and the resulting social factors. On the other hand, methadone maintenance treatment programs (MMTs) are seen to reduce the risks associated with heroin addiction such as overdoses, HIV or hepatitis infection from shared needles, and to impinge a slight change on the illicit drug market.

For those proponents of methadone treatment, in the early 1970s MMT facilities expanded swiftly and were declared a success. Yet, growth of both MMT clinics and the numbers of patients treated quickly stagnated; then as now, MMT is available to only about one in five persons with… heroin addiction. (“Addiction Treatment Forum” Vol. 15, #3 Summer 2006) First, how can we in the mental health field guide those who want to rid themselves of heroin addiction by referring them to clinics do so if they do not exist? It is evident there is a need for more governmental, as well as, state and local social services surrounding all drug addiction facets when addicts have nowhere to go for direction in receiving care.

Dr. Vincent Dole who died at age ninety-three in 2006 was considered by many the “Father of MMT.” He was highly respected for his gentle giant approach to patient advocacy. As you, the reader, will gather from unraveling the stories on the following pages, Deborah's counseling approach parallels that of Dole's who felt “…above all else, practitioners must listen to their patients to provide effective care.” Dole taught that substance dependence “…is foremost a chronic, relapsing medical disease, rather than simply a moral, mental, or behavioral problem.” These tenets held throughout Deborah's counseling career. We must not hold our addicted population to a personal moral judgment, but rather see and hear each individual as a soul whose life challenge is to stop abusing drugs and/or alcohol.

Deborah's counseling methodology was holistic in its approach. She openly confronted her clients as she would a friend or relative seeking her guidance. She used compassion, not judgment, while instructing her clients toward self-education, self-discovery, and self-recovery. These counseling methods both endeared her as “the counselor to get” and locked her into a decade of searching for better ways to help those she felt were stuck on the merry-go-round of a methadone system. She struggled, as many do, with the question of whether one addiction is better than another, for example methadone over other opiates. She struggled over heroin use passed from generation to generation among her clients. Deborah also struggled to introduce a compassionate and holistic concept of counseling by bridging the gap between labels and structure to one of caring and trust. She continually tried to devise avenues for her clients to rid themselves of their psychological dependence on methadone, therefore, releasing the need for lifetime treatment.

It is evident throughout this book that Deborah's passion for aiding those with addictions became her focus, as well as, to help redirect the way we as a society view and approach our drug addicted population. This passion led her to pose the compelling question: What's really going on?

At the time Deborah shared her writing notes with me so many years ago, I urged her to continue journaling her experiences and as the manuscript developed we worked together to form its balance between darkness and illumination. We shared our passion for client advocacy and discovered alternative ways to help those addicted to drugs and alcohol. I feel honored to complete her unfinished manuscript and bring her message of hope for a change in direction within the addiction recovery arena.

I have attempted to rewrite, edit, and gently interweave her powerful stories together, as well as, the immediate highs and lows of her own life to form a tapestry filled with pain, joy, defeat, and success. Although Deborah chose to call herself “Allie” in her journal notes, be assured the stories are true, the people are real, the life threatening incidents and tales of pain and death are...