Addiction & Substance Use Disorder: A Family's Journey

Transcript

[00:00:00] Ellie Pike: What are the ways you describe somebody you love? 

[music] 

Kim Offner: Funny. Wild. Unique. 

Ellie: For Kim Offner, it's been a journey to find the right words that describe her sister Kristy. 

Kim: She had this really awesome quality of just not caring what people thought. People tend to [00:00:30] grow into that, maybe in their 20s, but she had it from day one. 

Ellie: Time and healing have allowed these positive memories to grow stronger than some others. Memories of illness, addiction, pain, and loss. That's because Kim has walked the difficult path of loving someone fighting a losing battle to addiction. It's a journey a lot of us know all too well. 

According to SAMSHA, the United States Substance Abuse and Mental Health Services Administration, [00:01:00] one in 12 American adults have a substance use disorder. That number is only part of this story because when a daughter, son, sister, or brother falls into addiction, that loss is not isolated. Often the stories of these caregivers go untold. Today, we're taking the opportunity to sit with Kim and hear her story. She shares with us what she wishes she knew about addiction treatment a few years ago, and how she honors her sister today. [00:01:30] 

[music] 

Ellie: You're listening to Mental Note podcast. I'm Ellie Pike. 

[music] 

Ellie: Can you tell me some of your earliest memories of Kristy and just what your relationship was like? 

Kim: My sister and I [00:02:00] were two and a half years apart. [music] We grew up very close together, I mean like literally not just figuratively. Our bedroom was probably the size of a large walk-in closet for most people. We grew up in Northeast Philly. We were physically so close that we used to have handshakes before we went to sleep. We could actually high five before we'd lay down and go to bed or from in [00:02:30] the bed. We were three years apart in school, so we were in high school together, and because we were so close in age we always shared friends, we always shared birthday parties. We just did pretty much everything, one did, the other one did too. 

We were constantly forced to dress the same which I think I hated. I'm pretty sure she loved it, but my mom would come home with the same outfit for both of us, so we looked very much alike too. People often thought that we were [00:03:00] twins, and that was well into adulthood as well. 

Ellie: You guys were close starting as kids, through high school and then even in your young adult life and you did musical stuff together, you also worked together. It sounds really blissful, but I know that that's not exactly what the story was. At what point did you start to notice any mental health issues that your sister might be dealing with? 

Kim: When you look back, it's all like rose-colored obviously, [00:03:30] but there were some issues. Like I said, for someone that had so many friends in school and such a large supportive group, she still would have anxiety attacks almost every single morning before getting out of bed. My mom would come in and she would kind of baby us, she would lay our uniforms on the bed and wake us up and she let us sleep in, she was not the kind of mom that would get you up at like 5:00 AM. Kristy just every morning would be having [00:04:00] basically an anxiety attack, like a meltdown over not wanting to go to school. 

The reason behind that just didn't really make any sense because like I said, she wasn't being picked on, she wasn't being bullied, she had plenty of friends and activities there. I really do think that that was just one of the first signs of an anxiety disorder that she was dealing with, that we weren't really sure what that was. 

[music] 

Ellie: Did she talk about that with you all? 

Kim: No. As she got older, she opened up [00:04:30] more about it. She would talk about having depression and anxiety, but she also had this very tough persona where she would kind of play it off. You knew that it was an issue for her and she would verbalize that to you, but she also liked to keep this persona of being like, "Oh, but it's really not that big of a deal," and make jokes about it. I think that that was one of her ways of dealing with it and letting people know that this was happening, but [00:05:00] also she didn't ever want anyone to be overly concerned for her. As far as seeking a therapist or anything, she had absolutely no interest in that. 

Ellie: That is really interesting because I think it's something that's really relatable for a lot of people because anxiety and depression can just kind of creep in, and eventually, for a lot of people kind of become their M.O. and how they function. I'm curious if she didn't talk a lot about it, how [00:05:30] did she start to cope with her anxiety? 

Kim: That's where the story takes a turn. [thunder] Growing up, she was doing the same things that every teenager was doing, we were all doing, drinking a little bit on the weekends, maybe smoking. That was never really any kind of alarm. That's pretty standard for people who grew up around this area. The timeline is a little iffy because we're not entirely [00:06:00] sure when it started turning, but that's when she started getting into some harder stuff, and I think that it did have everything to do with maybe trying to cope with whatever was going on with her, that she just did not want to seek professional help for. I think that that is 100% the reason why she started dabbling in some harder drugs to try to cope with those feelings of anxiety and depression. 

Ellie: When she started to use substances to cope a little bit more, how did that affect [00:06:30] her relationships with you and your family? 

Kim: After high school, we still remained extremely close. We worked at the same restaurant together, so I saw her five days a week. Even though I wasn't living at home anymore, she was only about 20 minutes away, and I saw her almost every day. It was a singing restaurant, so we were all weird little trying to be actors and singers and stuff, so it was a very unique place, and there weren't that many customers, so that gave us a lot of [00:07:00] time to sit around and talk about everything. I mean everything from just like what was on Sex in the City that day to like your thoughts on the universe energy and God. 

I think that is what bonded all of us so strongly is that we just had so much time to talk and everyone was so open. [music] That time with her, was hands down some of the best memories that I have with her, but [00:07:30] that's also when the turn happened. 

Ellie: Kim began to notice small changes in her sister's personality. Changes that felt off-putting. 

Kim: Her depression kicked up. She didn't really seem to be getting a whole lot of joy out of doing the things that we used to do, just such as hanging out. We were all in our early 20s, there wasn't really much else to do, so we'd spent a lot of time together on weeknights, and she just [00:08:00] stopped coming around. Then it started in on her finances. She didn't have any money, which was really strange because we worked at the same place, so I knew roughly what she was making, but she always seemed to have some reason. That's when I think when I started realizing. 

It was actually my birthday six years ago, and she couldn't afford to come to this dinner that might have cost maybe $20 bucks. I think that that's when I knew something was weird. In retrospect, [00:08:30] everything's 2020, but I think that that's when I started to realize. Our relationship at that point did start to degrade a little bit. 

[music] 

Ellie: At what point did you really realize what was going on, and at what point did you feel really concerned about her well being? 

Kim: This is how I found out actually that she had a [00:09:00] problem with substance use. I was no longer at the restaurant, so I wasn't really seeing her, because I wasn't working there anymore. She called me one day and asked to borrow $500. She had a good reason, and our mutual friends found out about it, and then they took me out to lunch and sat me down and basically told me that they had known for a little while that she had a problem with Percocets, [00:09:30] but they weren't comfortable telling me, they wanted her to tell me. They weren't sure the gravity of the situation. 

I think she was obviously downplaying it to them, and maybe giving them a little bit but not telling them exactly how bad it was, how deep into it she was. Then when they heard that she had tried to borrow this money from me, and then I found out that she also tried to borrow money from someone else at the very same time, that it was obvious that she was in some trouble, so that's how I found out. 

[00:10:00] Ellie: Then what did that look like after that point? 

Kim: We had to confront all right. I told my mom. She just could not believe it. I'm sure a lot of people can relate to this next statement. You just kind of think to yourself like, that would never happen to this person because they're too smart for that. That's what we used to think. She's too smart for that. 

Ellie: As Kim learned more about substance abuse, she discovered intelligence levels have nothing [00:10:30] to do with addiction. 

Kim: That's kind of when the rehab train started. My mother tried to force her to go to therapy, go to outpatient, IOP. Tried to get her to go to residential treatment. She of course was downplaying how bad it was but it was at this point, that's when it took a really steep decline. We actually couldn't get her [00:11:00] to go to residential or inpatient until we threw an intervention. 

We hired an interventionist to come to the house. After 12 hours of letter reading and trying to convince her and beg her and beg her to go because at that point, it had progressed pretty rapidly to some even harder things. Percocets are dangerous in themselves but in Philly, we also have a huge problem with the heroin and [00:11:30] fentanyl. It's a massive issue here as it is around the country but especially in parts of the city. It had progressed to that point and we begged her and begged her and we finally got her to go. Then that was just a cycling thing for the next, maybe year. She would go in, she would come out. I just don't know if she was ever bought into it. 

Ellie: I can only imagine just how helpless it [00:12:00] felt to be her sibling, where you're not her caregiver. You're not her parents. You're not her financial support but you truly cared about her. You wanted her to get help. What did that looked like from your perspective as the sibling trying to support and then also trying to find the resources that you thought were best for her? 

Kim: It is difficult being a sibling because you aren't the parent. You can't force them to do anything. I feel like, on one hand, I want it to be there for [00:12:30] her and I was. I was offering all of my love and support but on the other hand, I was also trying to keep some sanity for myself and some self-preservation. Recovery wasn't really the goal for her. I think that her goal at that point was just to go and appease us and figure out how to get back to it, which I know is the case for a lot of people. Sometimes it takes quite a while before you click on and you're ready to start that actual recovery journey [00:13:00] 

That was difficult for me to watch because I wasn't sure if she was invested. While I was trying to help as much as possible, I was also trying to keep myself sane because obviously at that point, I personally don't struggle with anxiety and depression but I will say that there was no avoiding it at that point. It's like, every phone call you got for two years, I was afraid it was going to be "the [00:13:30] phone call". [music] 

Ellie: That is such a scary way to live. I'm sure you felt so helpless. I imagine there was some sort of guilt that you also felt because you had to create some boundaries to preserve your own self-care, your own time. What was that like for you? I don't want to put words in your mouth but did you ever feel guilt for doing that? 

Kim: [00:14:00] Yes, absolutely. I feel like, we all did because there's just never enough that you can do or that's what it feels like, anyway. I was still heavily involved but over the course of those two years, a lot of her friends had to take a back seat. They would always answer when she needed something or talk with her but I know a lot of my friends have very similar feelings of being like, we just didn't [00:14:30] know what to do. We're not trained in this. We tried all of our resources and nothing that we've done has fixed or helped anything so I just need to kind of take a step back. 

Yes, the guilt thing is huge. I think that that's a pretty standard across the board for people who are involved with people, their loved ones that are suffering. 

Ellie: Absolutely. I certainly agree. I don't think you are alone in that. I think it's an important thing [00:15:00] for other listeners to hear that they're not alone in feeling that way because that can feel wrong to feel guilty when there's someone else that's suffering. There's someone else that needs care. I'm curious when you all were in that situation and when you did try to step in and help. You were trying to figure out what treatment looked like and you hired an interventionist. How did you guys actually pick a treatment center? There's a ton of them and you can Google it all over the place in each city in each state. [00:15:30] How did you find what you felt like was the best? 

Kim: That was one of the most difficult parts. If you're in Philadelphia, you throw a rock you'll hit three of them. They're everywhere so you're right. It was really difficult to try to pick that. Our interventionist was great. He helped us choose a couple places in the beginning. The initial one that we sent her to he helped pick out. After that, it was just my mom on Google. Some of them were good and some of them were [00:16:00] really bad. 

I don't want to scare anyone but at some of these treatment centers, we know that she was using in the treatment center. That they were all using in the treatment center. We know that people would just elope and all the time. There were just a lot of issues with several of them. I wish that I knew then what I know now about treatment centers and the differences. There are resources that I was unfamiliar with at that point, where you can have people try to help you, pick the best spot that fits and find [00:16:30] one that is in network with insurance. Hopefully is just a treatment center that's going to actually hopefully work for that person. 

Ellie: What Kim is talking about is so important. Independent journalists have done a lot of recent work, uncovering how some places that call themselves treatment centers are simply using the people in their care to get money from insurance or worse, sending them out as unpaid labor. [00:17:00] For further listening the podcast Reveal from the Center for Investigative Reporting has done a lot of good work here. All that systemic abuse can leave people at a loss for where to turn in crisis. That's why I invited Linda Lewaniak to join this episode. 

She's both the regional clinical director at Pathlight Behavioral Health Centers and Eating Recovery Center. Also benefits from more than 25 years of experience as a licensed clinical social worker [00:17:30] and certified advanced addictions and other drug counselor. Linda will help us understand what families go through when caring for someone with substance use disorder. How they find effective treatment options, and what to expect when loving someone on the road to recovery. 

Sidenote, we want to be upfront that Linda is employed by the treatment centers that sponsor Mental Note. However, we talk about resources outside of ERC and Pathlight. Linda's perspective comes from years of [00:18:00] working in the substance abuse field. She offers practical advice for families seeking help for substance use disorder. Linda, can you talk a little bit about the guilt that caregivers and friends often feel when caring for a loved one with substance use disorder? 

Linda Lewaniak: I think there's guilt is one of the emotions if there's a range of emotions. I think the guilt really is the underlying guilt is the helplessness because they feel like, they can't do anything to make a difference. They feel like, they're going to struggle. They feel like, they're going to- anything they do intervention wise, doesn't help the problem. I think they also feel helpless which leads to feeling guilty with then leads to feeling anger and resentment. I think there's a process of what that looks like. Where I think that caregivers really need to do is get education. 

Ellie: Linda says it's critical that families educate themselves on what addiction is and how it affects their family member. 

Linda: Addiction is a disease and it's a disease [00:19:00] of the brain. It changes on the brain structurally and functionally. I think that's been really the biggest piece for me in regarding helping people with that. Also having them go to options like, Al-Anon or AA that can get support from other folks. Addiction is a very shaming disease and people don't want to talk about it being shameful. I think that when you have cancer, everyone runs to you. When you have an addiction, people run away from you [music] [00:19:30] I think it's critical that people get help and get education regarding that. 

Ellie: When we talk about finding treatment, how do families go about finding good treatment? Where do they go and what should they look for? 

Linda: Well, one of the things you can go on it's called findtreatment.gov. It's on the SAMHSA website. The other place that I always encourage family members to get help or look or understand is on the National Institute of Alcohol and Drug Abuse, which is the NIDA [00:20:00] website really can give you some good options with it. I think though when you are looking for a treatment program, there's lots out there and no one treatment fits all and I think that's super important for people to know because it's hard and sometimes it takes two or three treatments before someone can maintain sobriety, maintain change. 

I think that it's important that we start to look for things in a treatment center that's important. For instance, we need to know that addiction is complex and it's a [00:20:30] treatable disease and it affects brain functioning and behavior. We need to understand there's no single treatment with death right for everyone and that's the really tricky part. 

Ellie: It's tricky because effective treatment has a lot of moving parts to it. For starters, there's a strong sense of urgency. Treatment needs to happen ASAP. 

Linda: They say they want help, you got to take them right then and there. 

Ellie: Next treatment does not look like what we see on TV. It's often a much longer process. 

Linda: [00:21:00] Research further indicators, they've got to be in some type of formal treatment for about nine months. 

Ellie: Finally, substance abuse treatment is not simply about substance abuse. There are underlying issues that a person uses their addiction to cope with. These are called comorbid disorders. 

Linda: The effective treatment addresses all the needs of patients. Not just alcohol drug use and mood disorders, the medical components, high blood pressure, diabetes, any of those types of things along with sometimes there's housing issues. [00:21:30] Sometimes they've messed up every relationship they have, may have no place to live. It's really dealing with all of those pieces of the patient's needs or your loved one's needs. 

Ellie: After that, follow treatment guidelines, by stepping down from higher levels of care, like residential treatment to a partial hospitalization or day treatment, then onto intensive outpatient. Basically, avoid extreme jumps from detox to outpatient or something similarly jarring. Once treatment has finished, [00:22:00] the healing process is far from over. Your loved one will need a lot of support to take what they've learned and grow a new life. 

Linda: You learn a lot of skills in treatment and to make that change and maintain that change is really hard. 

Ellie: Connect with support groups, find outpatient therapists, and psychiatrists to help prevent relapse. You may even need to get creative with your treatment team to find the right fit. 

Linda: I had a call recently from a woman who was married to a man who's gone to treatment twice and she's like, "None of the treatments are working." [00:22:30] She said, "I think this equine therapy, these people riding horses or getting close to horses." I said, "If that's something he's really into connecting, they have something to try." The next piece that I look at is medications. Are they getting medications and are they getting behavioral therapies? Medication is not just for the depression or the anxiety or for the medical complications like high blood pressure diabetes, but it's also for we've to prevention [00:23:00] that solution. The relapse prevention meds for alcohol and opiates. 

Ellie: It's a lot, I know, but a good treatment team can help create a roadmap to recovery. Kim says her family didn't realize all the options that were out there. 

Kim: I wish that I knew then what I know now that there are some other options and I'm not saying that these work for everyone, but I do wish that we had given them a try since we didn't even [00:23:30] explore these. Art therapy, music therapy, she was a musician. I think that something like that like she was completely silent when she would go into her individual therapist, she wouldn't speak to them. I wish that we had known that these other avenues exist, so that maybe that would have opened her up a little bit. It might've been a way to get her to talk about what was going on. 

There are other options if you've tried everything, look for something else because I wish that we had done that. [00:24:00] There are some other things out there that we were completely unaware of. 

[music] 

Kim: Unfortunately, three years ago, yesterday, February 17th, my sister did pass away from an accidental overdose. After that, things have obviously changed dramatically for [00:24:30] myself and my family. Again, I keep reiterating this, but I know that we're not alone in this. Unfortunately, in Philadelphia alone in the past year, the overdose rate has just absolutely skyrocketed. It's kind of rampant and out of control. We're in a lot of company around here. 

Last night, a group of friends, and I got together to just do some reminiscing [00:25:00] and we pulled angel cards and just were talking about Kristy and holding crystals and just trying to connect with her. The one thing that we kept bringing up is that she's definitely a peace now. 

Ellie: When you look at losing your sister, you're able to make some peace with it knowing that she's at peace [00:25:30] and not wrestling with mental health issues and substance use disorder anymore. Kim, you have so much grief from losing your sister and you have so much love from your relationship with her, how have you dealt with that grief and love in the long run? 

Kim: I was resistant to do any of the family groups or anything while she was struggling. I was resistant to go to therapy after she passed, but just a few weeks ago, coming up on her three year anniversary, I made the decision to seek [00:26:00] a therapist. The reason behind that is just for the past three years, a lot of my friends are sharing in this grief as well. If you're a friend of a person struggling and listening to this, no one's negating your struggle. It's just as difficult, it's extremely hard to watch a friend go down that path and I've relied on my friends to take care of me when I'm having a little bit of a breakdown over it, or if I'm getting really sad or depressed and they're happy to do it. 

They're wonderful, but [00:26:30] I decided that it was time that I go seek professional therapy so I can unpack that with someone else and not just rely on them because I know they're struggling as well. I know that while they're always happy to do it, it was finally for me to speak with someone and so far it's been really great. It's just been a really nice way to unpack a lot of what happened with someone who has no idea who she was or anything and that absolutely suggest it for anyone that's I wish I had done it when she was struggling. Maybe I would have gotten some tools to help her. [00:27:00] Yes, I would 100% recommend seeking some therapy if you're dealing with this kind of stuff. 

Ellie: Thank you. I think that that's such a reminder that there's so many journeys when there's mental health issues. There's your sister's journey and then there's your parents' journey of learning how to help but also dealing with their own grief and sadness and inks at the same time. Then there's your journey and so I really like that you are taking care of yourself on your journey and through your grief, but I know that this has greatly, [00:27:30] greatly impacted you and your life and the trajectory of what you're doing. Can you talk a little bit about how you have memorialized her with your actions and with your fundraising efforts and awareness efforts? 

Kim: Yeah, absolutely. I mentioned that I was doing pharma when she was sick and when she died. I wasn't selling opioids or pain medication or anything like that, that's related to this, but I still [00:28:00] felt like I was part of this world that I didn't want to be in anymore. I also was just showing up to work and thinking like, why am I doing this? Why am I even here? Who cares? So I quit. I knew that I didn't want to do pharma anymore, but I didn't really know what I wanted to do. I had no idea that this kind of position existed and I got a call from a recruiter out of the blue, and I got this job at Eating Recovery [00:28:30] Center. That decision has been one of the best ones that I've made since her passing. 

Ellie: Kim is now a professional relations liaison at ERC and Pathlight. She spends her time educating clinicians about the latest research in the field and treatment options for their clients. Essentially, she's providing the resources she wishes her family had years ago. 

Kim: It's amazing that I get to incorporate Kristy into my everyday life. I talk about [00:29:00] her frequently to try to relate to people and let them know that I do get it, that I'm not just some person that just doesn't understand like I absolutely get it. I think that that's been extremely helpful. 

Ellie: The career change was not all that Kim started as a result of her sister's illness. She also began fundraising for artistic young students like her sister, so that they can have resources to pursue their craft. 

Kim: Something else that we've done to memorialize Kristy [00:29:30] is we started a fundraiser that's called fishing for Kristy. After her band fish, we threw a massive fundraiser in September, and we raised enough money to give two students at Archbishop Ryan, where that's where we both went to high school and we planned to do that for as long as we possibly can. 

The more you talk about it, the more you find out that so many other people are going through the exact same thing. As soon as we can drop the stigma and [00:30:00] just discuss it as if it's like cancer or a broken leg, then I feel like treatment options are going to get better and also more readily available and we're going to catch it sooner, which will definitely give your loved one or you a better chance at recovery. 

Ellie: Absolutely, I second all of what you're saying, and I'm so grateful to have your voice on the podcast and sharing your story so that you can break some of that stigma. I have one last question for you. When you look back on your [00:30:30] sister and your memories of Kristy, do you see Kristy aside from the substance use disorder, or is your memory of her really colored by addiction? 

Kim: The addiction part is completely gone. While she was going through it, I'll be the first to say it, you're allowed to feel everything that you're feeling. There are different ways to go about expressing those feelings and different things you can do, but you're allowed to feel how you're feeling and I was extremely frustrated with her a lot of times, [00:31:00] extremely angry with her. She was not an easy person to be around at that time. Throughout all of it, I always loved her obviously, but she made it really difficult at times. 

After she passed, it just all went away. At this point when I look back, we were extremely close our entire lives, but some of my favorite memories of her and some of my strongest memories of her are [00:31:30] those three years that we worked at that restaurant together so I feel like when I look back, that's the Kristy that I'm picturing. 

Ellie: I am so glad that you can share that and the reason I say that is because there's always a human behind suffering and there's always a human behind mental health issues or any kind of disorder. To be able to separate the human from the disorder, I think is [00:32:00] just so important for your memory, but also in those present moments. Any caregivers and families listening, I think that is the challenge. It's so easy to get mad, but maybe it's mad at the disorder, not at this human that you love so deeply. 

Kim: You do really have to keep that in mind because like I said, and I'll freely admit it because I'm sure a lot of people feel the same way, that I was very, very angry at her a lot of the time when she was doing those things that the addiction [00:32:30] caused her to do. When she'd be clear-headed, we would have frank discussions about it and sometimes she would say that it was like she wasn't even driving the car anymore, that she had literally been hijacked. 

The person that's yelling at you stealing, that's not your loved one. They're no longer in the driver's seat and you need to remember that because it's the disorder that's causing them to act that way and the sooner you can get to the bottom of it, the sooner you can get your loved one back. 

[music] 

Ellie: [00:33:00] Kim, thank you so much for sharing your story and I'm so sorry that you did not get your loved one back in this story here, but I am really glad that your memories of your loved one are of truly Kristy and of your best friend and of the wild, creative, and unique person that she was. Thank you so much for sharing her story with us. 

Kim: Thanks, Ellie. 

[music 

Ellie: Kim's story [00:33:30] reminds me about how important it is to see the human behind the disorder, both in substance abuse and beyond. May we all take the time to see the person trapped within the monster when we encounter addiction, anxiety, depression, and destructive behavior. To that end, nobody can support others if they are not being supported themselves. 

We threw out a lot of options for both treatment and family support in this episode. Places like SAMHSA, AA, or Al-Anon are [00:34:00] great spots to start. We'll also have a list of those on our website, mentalnotepodcast.com. While you're there, sign up for our newsletter. It's a great way to stay connected and get it behind the scenes look into our Kims' lives. 

Mental Note is brought to you by the good folks at Eating Recovery Center and the Pathlight Behavioral Health Centers. They have teams of licensed therapists you can speak to right now to see if in-person [00:34:30] or virtual treatment is right for you. Simply call (877) 411-9578. Our show is produced and hosted by me, Ellie Pike, directed by Sam Pike and edited by Josh Wright and Sam Pike. Till next time. 

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Presented by

Ellie Pike, MA, LPC

Ellie Pike is the Sr. Manager of Alumni/Family/Community Outreach at ERC & Pathlight Behavioral Health Centers. Over the years, she creatively combined her passions for clinical work with…