In fact, most people recover, often on their own. Here are some of their stories.
Credit…Ryan Christopher Jones for The New York Times
Filthy hands gripping bloody needles, pregnant women shooting up, angelic toddlers in car seats with their parents slumped upfront, overdosed — media images of the opioid crisis are relentlessly dire.
Fortunately, this is not the whole story. Around two million Americans are addicted to opioids. Yet many more have overcome their opioid problems. A large national population study found that almost all of those who once met criteria for prescription opioid-use disorder achieved remission during their lifetimes — and half of those recovered within five years. Although heroin and street fentanyl are more dangerous, most of those who avoid fatal overdoses recover from addiction.
To improve the odds, we need to recognize and champion recovery — and the wide variety of forms it can take. In media and pop culture, when recovering people are seen at all, one type usually appears: someone who goes to rehab and then abstains from all drugs by relying on 12-step programs like Narcotics Anonymous.
In fact, other recovery journeys are more common. For example, nearly half of those with prescription opioid addiction are able to recover without formal treatment or self-help participation.
Moreover, many of those who recover do it through professional treatment with medications like methadone or buprenorphine, not through abstinence. Studies, including one of all patients in Britain treated for opioid addiction between 2005 and 2009, show that these two medications are the only treatments that reduce mortality by half or more when used long-term — and they cut relapse rates more than an abstinence approach.
Other people take their own routes entirely. We find new passions in relationships, parenting, culture, exercise, work, art, spirituality, activism and community service. Some recover primarily by learning better ways to manage the trauma and mental illness that underlie many addictions. Some even kick opioids by using marijuana or psychedelic drugs.
As someone who suffered from heroin addiction myself, I’d like to introduce you to a few people who have followed diverse trajectories out of addiction. My own nearly 30-year recovery started with traditional rehab and abstinence, which I practiced for 13 years. Now, however, it includes medical use of antidepressants, exercise, strong relationships, deep commitment to my work and moderate use of some legal substances.
I believe people like me can no longer stay silent — our stories are the only antidote to a picture of addiction that fails to include recovery.
Sam Greenwood, 33, owns a small business and lives in Cranston, R.I. His addiction was forged by depression during puberty. In eighth grade, he considered suicide.
“I was trying to find something that I could take that would make me feel good and less lonely,” he said. His prescription opioid problem — like that of most who misuse these drugs — began with someone else’s medication, in his case, Vicodin, prescribed to his girlfriend. He was 16. By 22, he was buying pills online, eventually including illegally-manufactured opioids and untested anti-anxiety medications.
After two overdoses that required hospitalization, his wife insisted that he get help. And, for the first time, his depression was diagnosed, along with attention-deficit hyperactivity disorder, both conditions that sharply raise risk for addiction. After several relapses, he stabilized on buprenorphine (Suboxone) and an antidepressant. He also attended meetings of SMART Recovery, a secular abstinence-focused support group.
“What I connected with most was the idea that it’s all about choices and that you’re not powerless,” he said. He attended even during relapses. “I’d come back, kind of hanging my head after one of those episodes; everyone was so supportive and so emphatic about making sure I didn’t think I was starting over.”
Brooke Feldman, 37, served as a student speaker when she graduated from the University of Pennsylvania with a degree in social work in May. But that was not the kind of future she imagined as a child. Raised mainly by her father, stepmother and in institutions, she saw her mother, who was addicted to heroin, for the last time when she was 4. A sense of abandonment haunted her.
“I grew up believing that addiction was a choice and feeling really confused about why my mom would choose to use drugs over showing up for me and my brother and being in our lives,” she said.
At 13, she ran away. When her father found her, she demanded her mother’s address. After years of equivocation, he admitted that she’d recently died of a heroin overdose. “I kind of lost my mother twice,” she said.
Ms. Feldman became suicidal and defiant. Her teens were spent cycling through psychiatric hospitals and juvenile prisons, often drinking or heavily medicated. She came out as a lesbian at 18. At 21, she was introduced to Percocet by a girlfriend and occasional use soon turned daily.
But as she watched friends transition to heroin, the drug that killed her mother, she decided to seek treatment. “I very much prided myself on not being like my mom, and it was this line in the sand for me,” she said.
“What we see in the media is a tale of addiction in which us white folks are painted simply as victims of big bad pharma. This simply was not my experience.”
She found solace in the fellowship of 12-step meetings in 2005. She also began working at a recovery community center, which supported people through multiple recovery paths. “While for myself and many, recovery includes abstinence from alcohol and other drugs, recovery does not have to include abstinence.”
Zach Siegel, a 29-year-old writer, said he always felt like “the odd man out” growing up in the suburbs of Chicago. He started drinking by sneaking cocktails at Bar and Bat Mitzvahs when he was 13 and soon began smoking marijuana and trying pills as well.
In high school, he discovered opioids. The drugs made him feel “comfortable in my body,” he said. “That was a very powerful feeling for me as someone who had really bad anxiety and had been very self-conscious.”
His addiction took off at 17, after a friend sold him OxyContin. Before long, he’d switched to cheaper heroin. His parents sent him to several inpatient and outpatient rehabs.
“I gave those 12 steps a really honest try,” he said. But what ultimately helped him most was writing and studying the science of addiction.
“I just put on paper what I thought was going on with me, and I could also read what other people thought was going on with them,” he said. “I didn’t know what I was doing that at the time, but I feel like I was making sense of my story.”
His relationships with his girlfriend, his family and friends have also been crucial. “So long as those are supportive and loving and stable, I don’t really feel the need to fill any voids or comfort myself.”
He has not used opioids since 2012 but says he does drink alcohol and uses marijuana in moderation, where it is legal.
Jacques Hargrove, 64, has taught high school math for more than three decades. He grew up in Nashville, the child of a postal worker and a homemaker. He excelled in school and attended Fisk University, where he began frequently smoking marijuana and drinking.
But when he was a college freshman, his brother asked him to try something — injecting heroin. Before long, he was selling the drug. “At the time, you couldn’t tell me that it wasn’t the best thing in the world because it made me feel so good.”
In 1975, however, the friends he sold drugs with were indicted. “I decided I was done,” he said. “On Christmas Day, I shot myself up the last time and I started drinking. I drank until the 29th and that monkey on my back was gone.”
His friends, however, were in prison or had criminal records. “They got out and they went back to the same street life,” he said.
He graduated college and became a successful high school math teacher, now nearing retirement. He drinks “sometimes, but not a lot” and this is the first time he has ever told his story. He wanted to share it “to help others” and to show that addiction doesn’t always last a lifetime.
Valerie Ross Zhaawendaagozikwe, 26, is a technician at an addiction rehabilitation center in Minnesota. Her addiction was born in heartbreak when her first love went to prison at 17.
“I turned to drinking and I was like, ‘This is the only way I’m going to get rid of this pain,’ ” she said. Her younger sister was already using prescription pain pills and heroin — and soon, Valerie was, too.
“A lot of Native people have ongoing trauma,” she said. Indeed, some experts have labeled heroin addiction as the product of a “shattered childhood” because, according to one study, at least 90 percent of people who become addicted have had early traumatic experience. “It’s like a deep hurt that we don’t understand,” she said.
As a child, Ms. Zhaawendaagozikwe, a member of the Muckleshoot Indian Tribe, said she was sexually abused. Opioids made her feel invincible. “They took all the bad feelings away and it was replaced by euphoria."
Between the age of 22 and 24, Valerie attempted treatment at least 20 times; she had about nine overdoses. During her last overdose, she briefly went blind, which terrified her. She tried conventional treatment, but it didn’t work. She returned to her roots to find recovery.
She began attending Native American ceremonies and praying using ceremonial pipes and tobacco. “I try and tell people that if you learn those songs and if you drum, that can change the way that you think and your mind and the way you feel,” she said.
She met the man who became her partner at a ceremony and soon became pregnant. “If I didn’t have my son, I’m not sure how far I would’ve made it,” she said.
55-year-old Tino Fuentes grew up in New York City, of Puerto Rican and Cuban descent. At 6, he found his uncle overdosed in a bathroom, a needle still in his arm. In first grade, a teacher told him he needn’t bother with schoolwork because he would only grow up to “be a dishwasher or a janitor.”
At an early age, he began selling and using marijuana and cocaine. He rose in the drug trade to running corners on the Lower East Side, the Bronx and Brooklyn, becoming addicted to heroin along the way. But in the 1980s, the police cracked down hard on street sales — and Mr. Fuentes moved to Florida to avoid the heat. Gradually, he eased himself out of both selling and using.
He stopped taking heroin sometime in the 1990s by using methadone and buprenorphine acquired from a friend, and slowly tapering on his own.
When he first learned that people were distributing clean needles to prevent the spread of H.I.V., he didn’t believe it and went to see for himself. Soon, he was volunteering and then employed at a needle exchange. These days, he helps people test heroin for the presence of fentanyl: Research suggests that people take more precautions if they know that fentanyl or its derivatives are present.
“Just because you use drugs doesn’t mean that you should die,” he said.
Maia Szalavitz is the author of “Unbroken Brain: A Revolutionary New Way of Understanding Addiction.”
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