Patricia A. Roos is the author of the new book Surviving Alex: A Mother's Story of Love, Loss, and Addiction. Her son Alex died in 2015 of a heroin overdose at age 25. Her other books include Job Queues, Gender Queues. She is a professor emerita of sociology at Rutgers University.
Q: First of all, I'm so sorry for the loss of your son...
Why did you decide to write this memoir?
A: Thank you for your kind words. I wrote this memoir because I didn't want Alex to be simply yet another 2015 statistic. I wrote to honor him, so that his life would make a difference. And of course, research and writing was therapy and I needed questions answered.
Q: The writer David Herzberg said of the book, “Both a memorial and a sociological analysis, Surviving Alex shows us that addiction is indeed something to fear, but not for the reasons many of us assume.” What do you think of that description?
A: Interesting question. I don't know historian David Herzberg, so I'm not sure what he meant. But here is my take on it.
Many fear addiction, and consequently stigmatize those who use substances, and their families. Their stigma arises because they view users as "choosing" addiction because of personal "defects of character." Or they may believe that "addicts" have a brain disease, which reflects a compulsion that occurs from drug use (as the belief goes, once you take that first hit, you have the compulsion to keep taking drugs).
It's easy to stigmatize substance users if you buy that personalistic view of humanity. And if you share that view, the solution is relatively easy: send the users to jail and shun them and their families.
I most assuredly do not believe that addiction is due simply to choice, or to a broken brain. Alex asked many times, "Do you think I want this life?" We knew he didn't, but like many suffering in the insanity of addiction we had little access to what could have saved his life.
Viewing addiction as a sociologist, I believe that substance use arises because choices occur within specific contexts. What are those contexts?
People use drugs because they are self-medicating for psychological issues (e.g., anxiety, depression, trauma) and/or for socioeconomic reasons (e.g., poverty, unemployment, incarceration, racism).
Moreover, data suggest that most people who use drugs do not become addicted. Estimates are that only 10 percent of those who take drugs become addicted. So the question for Alex is why did he feel the need to self-medicate first through anorexia and then later in his life with heroin. We need to raise our eyes beyond personalistic to systemic explanations.
Q: What do you see as your son’s legacy?
A: Legacy is hard to describe for someone who was only 25 when he died. But as I wrote in my epilogue, I strongly believe that if that we had lived in a compassionate harm reduction world, as opposed to a punishing, criminal justice one, Alex might have survived.
Ultimately he needed more time. He needed more time to let his prefrontal cortex develop, to find solutions, and to learn to hope again. A different historical context, steeped in harm reduction compassion, might well have given him that extra time.
So perhaps Alex's legacy, through Surviving Alex, might well be that others may live because of what I learned about harm reduction. That's a damn good legacy.
Q: What impact did it have on you to write the book, and what do you hope people take away from it?
A: Writing Surviving Alex has had a huge impact on my life. I tried many forms of therapy and self-care, but it was turning my grief into action that made the difference for me. Writing op-eds, testifying before political groups, and getting involved in interest groups launched me into advocacy.
And then, of course, from p. 1, writing this book was therapy. Ultimately I wrote a sociological memoir, which allowed me to apply sociological insights to thinking and writing about addiction. From that moment on, I was writing for recovery, both my own, and for all those my book might help.
I have three goals that have driven this research from the beginning.
First, I want people to know what it's like to live with someone who uses drugs. Most people don't have a clue. I wrote both for those who live in such families, who understand the insanity of addiction, but also for those who think it couldn't happen to them. I want people to know that if it happened to my family, it could happen to any family.
Second, I want people to understand that I'm both a mom and a sociologist. I look at addiction as a sociologist would. As I describe above, I believe that those who use substances are self-medicating, that choices are made in particular contexts.
Third, I want to be involved in community action to do something about the overdose crisis affecting our country. Nearly 110,000 people died of drug overdose just in the last 12 months.
What are the implications of focusing on these three goals? Conventional explanations for addiction don't go far enough, and actively harm those who use substances and their families. The War on Drugs has failed. We can't incarcerate our way out of the problem.
Among needed strategies: We need to move beyond punishing, criminal justice approaches to those based on public health. We must recognize there are multiple paths to recovery, not simply abstinence-based approaches. We need treatment programs that use evidence-based medications, whch work to keep people alive. We must recognize that health care is a right not a privilege. Finally, we need to attack the stigma that remains stark and raging, even among medical providers. And, of course, many more.
Q: What are you working on now?
A: Now that I've finished writing the book, I am in the process of deciding what sorts of advocacy will best use my skills. The first responses to my book have been encouraging, and I hope to bring my book, and its sociological arguments, to an even broader audience.
--Interview with Deborah Kalb
