I Want to Understand

I read a book recently called Dreamland by Sam Quinones.  It's about the opiate epidemic in the US and how it came to be, from medical journal articles to pharmaceutical companies to pill mills and the Mexican dealers selling black tar heroin in small towns.  I don't know if my mother is/was on opiates.  But I assume so based on their being the norm at the time and the side effects I saw.

I've started reading a book about benzodiazepine use and addiction because benzos seem likely to have been prescribed to my mother too, based on her complaints and again what was common to prescribe.

I want to understand what happened with my mother.  The more I read, the more I feel unsure.  How much of her behavior was because of how she is?  And how much was because of what she was taking?  How can I find out what she was taking?  Even if I reached out to her and asked, I don't think she'd necessarily tell me.  And if she's as sedated as Dante said she was the last time he visited, who knows if she'd even remember what she has taken, or what she used to take, if she replied at all.

The only place I think I might be able to find a record of what my mother was taking is maybe in my grandmother's letters to my cousin.  But I haven't looked at them since the time I read through them for genealogical information and realized my grandmother -- the sanest, kindest, highest functioning person in my extended family -- habitually talked about me behind my back.  She judged me for not being concerned enough about my mother because I didn't come to her with my worries or tears.  I cried regularly about my mother, just not to her.  I remember sitting in my dorm room after my mom really went off the deep end, spending hours Googling her symptoms and behaviors and trying to figure out what was wrong with her.  I spent too much time on WebMD and the Mayo Clinic website because I thought it was a disease.  I feel so stupid.

It was years before I realized it was the pills, and even now as I read about opioids and benzodiazepines, I'm just now realizing just how much can be explained by the pills.  Example:  I thought when I didn't hear from my mother for days or weeks at a time (glorious breaks from her calling to yell at me, apropos of nothing) that she was going through a deep depression.  But she was probably just on pain pills.  She was probably mostly asleep.  The muscle weakness my mother insisted was some sort of progressive illness like multiple sclerosis and the doctors and I explained away as muscle atrophy from her refusal to get up and walk -- a common side effect of extended benzodiazepine use.  I should probably just do a search for most commonly prescribed pills in 2003 if I want to know what she started taking when she went well and truly off the deep end.  She had gone to the doctor to treat her sadness at the death of her brother.  I had asked her to just grieve instead -- told her her feelings were normal and wouldn't benefit from antidepressants -- but she took whatever that doctor gave her anyway.  This was six or seven years after the first time I saw her high on Soma (Carisoprodol, a muscle relaxant and non-benzodiazepine hypnotic).

I feel like an idiot.  I didn't understand anything about drugs.  I remember hearing about celebrities developing addictions to pain pills after surgery or injuries, but I didn't understand what that even meant or what that addiction looked like.  I didn't understand what being high on pills looked like.  When it came to what being high looked like, I had only seen caricatures of stoners in comedies on TV.   It seems from my grandmother's letters that everyone realized my mother was addicted to drugs but me, and I feel like an idiot.  When I was a freshman in high school, my mother had explained her behavior away with menopause (on the rare occasion she admitted it wasn't just me who was acting differently), and I was desperate to figure out what had happened that made her this way and how to prevent it taking hold of me too, since I had inherited half her DNA and assumed all of this was just happening to her and would do the same to me.  I had never seen my mother partake in so much as a glass of wine, and she was adamantly against any form of drugs.  Except the ones billed as medicine.  Then her adage of "little do good, lot do better" seemed to come into play.  Even when it came to Tylenol, she urged me to take more than the amount indicated on the bottle if the pain was "really bad," and she took god knows how many Tylenol herself everyday for as long as I can remember.  I wonder what her liver looks like.

I don't think my mother had any idea what she was getting herself into when she started with the Soma.  This all started in 1995 or 1996, around the same time doctors decided pain was "the fifth vital sign," no one should endure pain ever and, if you are in pain, you should drug yourself out of it.  Oxycontin was new to the market and a hot, highly prescribed "non-addictive" opioid (spoiler alert:  it's highly addictive and has killed a lot of people). 

The good news is I don't have to worry about inheriting any of my mother's madness, even come menopause.  The other good news is I understand more about pharmaceuticals now than at least 85% of the US population.  And I know not to take anything a doctor prescribes until I've thoroughly vetted it online and, even then, not if I can do without.  If I ever take morphine, it'll be because death is imminent because I don't want to have to try to STOP being addicted to it.  Had I been a high school athlete or gotten into a car accident that left me in pain, I probably would've been prescribed opiates and quite possibly ended up a situation like my mother's.  It happened a lot to other people at that time and for years afterward.  The only reason it didn't happen to me was luck.  But now I know at least.  Now I have information.  And I guess it's good my mother ended up in a nursing home after her last suicide attempt and her refusal to take care of herself (and our family's collective refusal to take care of  her anymore) because she might have died of an overdose by now if she were left to her own devices and dosing schedule.

My mother is the case study I teach my daughter.  They still do DARE or some variation on it in her school, but it doesn't go into enough detail if you ask me.  The "just say no" tagline implies a hit of pot and an oxycodone are equivalent, and if a kid comes to see that something like pot doesn't actually destroy their life, they might just assume the other one won't either.  Lack of nuanced understanding is dangerous when it comes to what we put in our bodies.  My mother's insistence that alcohol and sex are evil while indulging in prescription drugs and junk food multiple times a day is a good example of how black and white thinking fails us.

I wonder what she would be like if she weren't on the drugs.  I mean, she fit the criteria for borderline personality disorder before any of that.  But she started taking hypnotics and god knows what else when I was in eighth or ninth grade.  What would her non-drugged behavior even look like to adult me?  I don't know.  I don't trust my childhood memory and childhood interpretation of what she was like before the drugs.  She wasn't all bad by any means.  Sometimes she was great, and I loved her so much.  Would she still have drained my bank account?  Would she still have tried to turn my grandparents against me?  Would she still have tried to turn me against my dad?  Yes.  That started before the drugs.  Telling me he wasn't my "real" father and that I couldn't talk about it to anyone was earlier.  Telling me he'd never wanted me and had wanted to beat her into miscarrying me was earlier.  Telling me she'd let me decide if she should divorce him and that we'd be poor and have to find somewhere else to live was earlier.

I don't know what she'd be like now if not for the pills, but I trust this particular scenario has played out as well as it could for me.  Sometimes, since reading Dreamland, I think about reaching out to her.  I hadn't realized until that book just how much the deck was stacked against her NOT becoming an addict.  But I don't want her to have my phone number, and I don't want the nursing home to start demanding money from me (I'd never pay them, so it would just be frustrating for both of us).  I'd like to check in on her and see how she's doing and what she's doing, but I don't want to interact with her.  I'm not sure if it would be worse to let things go and maybe have some regrets when she dies, or to take the chance of appearing on her radar and what backlash that could prompt.  I wonder what drugs she's on now.  I wonder how she feels, or if she feels much of anything at all.