Surviving Alex

[Jaunty Guitar Music]

Mike: Welcome, everybody. This is Avoiding the Addiction Affliction, brought to you by Westwords Consulting and the Kenosha County Substance Abuse Coalition. I'm Mike McGowan.

Mike: Patricia Roos was a professor of sociology at Rutgers University when in 2015 she lost her son Alex at age 25 to a heroin overdose. As a professor who had devoted her career to the study and research of work, gender inequalities, work family dynamics, and addiction, Pat shifted her research and advocacy interests, turning grief into activism.

Mike: In her terrific new book, Surviving Alex, Pat weaves together the personal, and the sociological as she examines the broader set of factors implicated in mental health and substance use disorders. Welcome, Pat. Thanks for being with us.

Patricia: Thanks. Thanks for asking me, Mike. And also thanks for reading the book.

Patricia: It really makes a big difference when somebody's actually read the book. (laugh)

Mike: It's interesting. It's been fun for me to do these podcasts because I do get to read a lot, and I can't fathom anybody interviewing you without reading it. (chuckle) Well, anyway, what's the point?

Patricia: I can tell. I can tell when they don't.

Mike: I bet. I bet.

Mike: Well, we'll get into the sociological stuff in a little while, but first, Pat, tell us a little bit about Alex, because I think that always helps people.

Patricia: Yeah. What, what is there not to say? He was smart. He was athletic. He played baseball through high school little league, you know, all the way through high school.

Patricia: He was a black belt in karate and he had a huge network of friends. I mean, everybody, when I started to interview his friends I can't tell you how many of them said he was my best friend, you know. I'm not sure he counted me as his best friend, but he did. He had lots and lots of best friends and he was loving I mean you should have seen the way he was with his cousins and there are pictures in the book of him holding his cousins.

Patricia: He just loved every single one of them all. But he was one of the older ones on my husband's side of the family. And he just loved those. But also I think it's important to talk about how sensitive he was. Because when I started talking with other moms who lost their children or their relatives, they all said the same thing, that their kids were so sensitive, almost too sensitive for this world.

Patricia: And, you know, unfortunately he then started at a very young age and, and you know, we'll get into that about having anorexia when he was young, but then he started drinking soon after getting out of the eating disorder unit that he was in and taking drugs. And he used those to self medicate and that was really the you know, sort of the beginning of the difficulty that he faced was when he started drinking and started taking drugs and, you know, it was for self medication. And I think you also hear this a lot from parents and relatives who lost their kids and relatives is that, you know, clearly they're self medicating.

Mike: You know, you mentioned his friends. I was going to talk about them anyway, but it's interesting in the book, I'll paraphrase his friends described him as patient, but not right. Confident, but not. Happy, but lonely. Confident, but anxious. I thought it was interesting somewhere in the book, and you must've got this from one of his friends.

Mike: That Alex said that the only time he really felt included in the groups he wanted to be in when he was when he was selling weed.

Patricia: Yeah. And even before that he talked about when he was in rehab, he wrote long dissertations on, you know, what had been going on in his life and he talked about how drinking made him fit in.

Patricia: So for the selling the weed, it was drinking, drinking really helped him to fit in. Because he felt comfortable in his own skin, you know, he used that drinking to self medicate and you're right. That was his friends who saw that. He didn't get into his first choice of fraternity. He writes in this description of how he got into drugs and that.

Patricia: And that made him feel you know, insecure. He was at this very small college and when we would go up and visit him, which we did on multiple occasions, we would walk down the street and everybody said, Hey, Clark! Hey, Clark!

Mike: Right, right.

Patricia: His last name was Clark. And but he knew everybody. And yet it wasn't enough for him, you know, he found love, you know, it wasn't enough for him and it was really that need to have people around that sense of community was so important for him and I think that's one of the reasons that later on in his active addiction.

Patricia: The isolation that was created from him being alone because his friends didn't want to be around it, right? He began to alienate his friends and that became incredibly problematic for him. He needed those friends and it's precisely that community that could have made a difference in bringing him back from addiction.

Patricia: But he, in part, alienated them and, you know, the criminal justice system didn't help as well, I'm sure, get into.

Mike: Well, this is part of your life work, so you get this, I'm sure, better than most. But it's always interesting to me how what we perceive in somebody is not how they perceive themselves. And it's almost like you want to just say, look in the mirror.

Patricia: Right. Shake, you know. But, I mean, isn't that what insecurity is?

Mike: Yes.

Patricia: It's all about, it's like psychological. I mean, so many people now are so anxious and that gets in the way of them seeing themselves as the successful, you know, bright, athletic, enthusiastic person that he was, you know, it just. It wounded him in a way that is hard to fathom, right?

Patricia: As his parents. I mean, he was, we always said he was smarter and better looking at, you know, you name it, that he was better than we were. And yet, you know, those anxieties really restricted and, you know, reduced his sense of self. You're right. You just wanted to shake him and say you're wonderful, you know?

Mike: You start your book by stating that Tuesday, May 12, 2015, the day Alex took his life, was your worst day. We've had a number of parents on, obviously, who've been through this. I know you've talked to them, too. How difficult was it for you to write about that day, and did it help?

Patricia: Oh, yeah. Oh, yeah. I mean, people are, people don't understand why, you know, how it is that I can even write about it, but I don't understand how I could survive without writing about it.

Patricia: So, writing was what enabled me to learn to live with it to grieve over it, and, you know, really, I think my number one goal of my book is to make sure that people understand how it is to live and survive someone who has been you know, addicted to drugs and someone who has died because of drugs.

Patricia: And you know, I want people to see that. I want people to understand it. Because I think so many people don't really know what it's like in the middle of the nitty gritty and so I try to bring that live in my book and make sure that people understand it and, you know, kind of treat it like a scene, you know, different scenes, scene one, scene two, scene three, of what it's like to live through this. Because you know, if you can put yourself back in that situation, right, for three years when he was in active addiction, and we were both active professors in sociology, we had three kids at that point and It's like I look back on my calendars of the day and it's just impossible, you know, how do you survive something like that?

Patricia: But you do, you do because you put one foot in front of the other. You don't have any other choice, right? You have to do that. So you know, I think it's really important for me, it helped me understand it. It helped me to think it through in a sociological way, you know, use those sociological insights to understand.

Patricia: Why it happened to my family, right? Why is it that this, you know young, good looking, male, smart, from a normal family, right? A good family. How could this happen, right? That was really the kind of central. A question that I needed to ask in my book and that helped me because without that, I don't think I, (chuckle) I don't know how people do it.

Patricia: You know, a lot of people do it through activism, but I need to write, I still need to write about it.

Mike: Well, you know, you do an eloquent job of doing that. And there was a time where every time it seemed like you and your husband, Chip thought Alex was on the right track, something would happen.

Mike: And I think would be so beneficial to families that roller coaster, you know. Things are going well, and now there's a confrontation with campus authorities. And they're going well, then there's a bouncer at a frat. And then they're going well, then there's a DUI charge and law enforcement, blah, blah, blah. Right?

Mike: But do you see the roller coaster when you're in the middle of it?

Patricia: I don't know, I think it was later that I came to describe it as a carousel from hell, you know, it's a carousel ride from hell, which anybody who's in the addiction world will understand immediately. I mean, we all talk about it as being insanity, you know, and so I always talked about it as insanity.

Patricia: From early on, right, the insanity of being in this, but then I came to think about it as the carousel ride from hell, because that's really what it was, and, you know, for Alex, it was that confrontation with authority figures came early, came in his senior year in high school, right, when he decided he was gonna, you know, bring liquor to the winter school dance, you know, and like, I mean, his friends, even, even one's friends who are, who have their own problems.

Patricia: I said, it was just dumb. It was in his back pocket. You know, what administrator doesn't know that kids put you know, liquor, clear liquor in their water bottles, you know, dumb, dumb, dumb. Even the teacher, I talked with a teacher who found it and she says, come down. I'm like, what? Whatcha doing? So, but it continued, you know, his first semester in college he got arrested for underage drinking and then he got arrested at Penn State, you know, doing fraternity business.

Patricia: And so those kind of confrontations. He kind of settled down a little bit later, and then once he graduated that's when it really became even much more problematic. Because, you know, when you're in college, there's a kind of a consequence free zone and once that's gone, right, when you're out in the real world, there is no consequence free zone.

Patricia: You do something, and the police will pick you up and take you in, right, and they will arrest you and they will put you in jail. And so all of that began to happen to him.

Mike: Well, and you write about it. There's a line in your book that you do. I just stopped. It, the line is Alex overdosed again and again over the next 18 months.

Mike: I mean, that's so short. You get it right. So now there's, that's the consequence, right?

Patricia: Yeah you know I want people to understand what it's like, as I mentioned earlier, you know, because we were you know, we are just regular, normal, good family, you know, no poverty, no trauma that we know of, no abuse.

Patricia: And he reiterated this at every single, I got medical details from every organization in which he resided and he said it over and over and over again. No, no abuse, you know, no poverty, no this, all those things that are concurrent with addiction in some cases. So you know, that led to the question of what is it, you know, what is it that why did it happen to our family and that's what led me into the, to the kind of look at the broader kind of factors that a sociologist would look at and you know, in part, dealing with the criminal justice system and its trauma in it's own.

Mike: Well, let's talk about that broader perspective. And I thought about how to do this with you. And I thought, I'm just going to give you a couple of words and you can just react to them. All right.

Patricia: All right. I'll do it. I'll do it like short little sentences.

Mike: Well, you can even expand if you want to.

Mike: Let me start with this one. Since you just mentioned it, the law enforcement system.

Patricia: Yeah, I think that's the worst. You know, if I had to say, and that's really the core problem is that the war on drugs has been a disaster. It's a failure, but it's still happening out there in the world.

Patricia: And so, and I really believe that Alex could, you know, I wouldn't say would, could be still be alive if he hadn't have faced all those criminal justice situations that he did, all those sanctions. And what we need is that, is we need a public health approach so that you don't throw people in jail. Because they you know, they have, they possess marijuana.

Patricia: I mean, here it was in Alex was arrested for marijuana in 2014. And a few years later, marijuana was decriminalized in New Jersey. So here he was facing those kind of sanctions that didn't exist anymore. Just a few short years later, and you think is if we had set of laws like Portugal does, right?

Patricia: Then we wouldn't have those kind of sanctions for other kinds of drugs as well. And I think the trick here is, no, it's not a trick it's what we really need. It's what is so important is that we need you know, we need to treat it like a public health issue, and we need to give people more time, because I think with Alex, one of the things that I really feel strongly about is he needed more time.

Patricia: I talk about that in the epilogue, where if he had that extra time, right? He was only 15. And so here, all of these institutions that he was a part of, the rehabs and psychiatric hospitals that he resided in, I mean, how they treated him were all problematic, you know.

Mike: That was my next two words.

Mike: Go off on that. The treatment system.

Patricia: The treatment centers. So, I mean, you've got the kind of traditional treatment centers. Or the conventional treatment centers. In our case, they were all 12 step programs. Nowadays, people think about it as multiple steps you know, sort of, we need, we have multiple paths to recovery, not just a 12 step path.

Patricia: And, I mean, the 12 step path works for some. I had conversations with a number of people, friends of Alex's who are just adamantly supportive. But they're also smart enough to understand that it's not the path for everybody. And it was not the path for Alex.

Mike: Mm hmm.

Patricia: And so I think if we had treatment systems that actually had medication assisted treatment and had medications for opioid use disorder we would be more successful.

Patricia: And then you have like the psychiatric hospital that he went to, which was a disaster because it was so. I mean, you know, the biases that you have. I mean, here are people who are treating people with substance use issues and they thought they have all those same kind of biases that most people in the population, probably most people in the population still have.

Patricia: That should not be part of the treatment system. So.

Patricia: That's my, that's my rant. (laugh)

Mike: No, that's it. We've talked about it here before. If we're going to reduce stigma, let's start with the people that are actually doing the treatment.

Patricia: Exactly, exactly.

Mike: Talk about big pharma.

Patricia: So big pharma was less an issue with Alex because he was never prescribed oxys, for example, but he got them right.

Patricia: He got them through informal markets. And So it was an issue for him in that he took those drugs, but he didn't get them because for some people who get addicted, who have them for, you know, pains or various kind of car accidents or something like that. So for him, I mean, big pharma is clearly shows us that, (chuckle) you know, that addiction is something that if you bring those pills, people will use them.

Patricia: And, you know, some people will get addicted. The figure that's usually banded about is that 10% of people who use drugs, opioids get addicted. Right. So, you know, I think, well, why was Alex part of that 10%, right? (laugh)

Mike: Yeah. Well as a sociologist. There's the issue of insurance parity as well and access to care.

Patricia: Yeah, I mean, access is really important. We had, we were very lucky. We both worked for the State University of New Jersey. And so we had, I call it Cadillac insurance, but even so we did not get reimbursed for that psychiatric hospital. (chuckle) They never reimbursed us. And they believed that they didn't need to reimburse us.

Patricia: And I took them all the way up the, (chuckle) you know, all the way up the line as far as I could and you know, I never got any kind of recompense, reimbursement whatsoever. I mean, ours was fairly mild compared to some friends that I have, who had spent hundreds of thousands of dollars and were never reimbursed, but I got involved in the whole insurance parody issue in New Jersey and we successfully... I was part of a small group of people called denied treatment who successfully wrought that.

Patricia: We testified to one of the committees in the state government and Phil Murphy signed that law a couple of years later. And so that felt really good. It's still, it's not working (chuckle) because the states, you know, sort of, it's successful in the breach, as you might say that unfortunately. But it's a step in the right direction because that law has been around since 2008, the parody law has been around since 2008, but it's still a problem, still a major problem.

Mike: You keep leading me into the next couple of works. No, it's great. It's like you're reading my mind. The, I wanted you to comment on I'll just say this as blandly as I can, political will or the lack thereof.

Patricia: Oh, my God. Yeah, that's I think it's huge now. If you think about too many politicians, they kind of go with the wind and they want to be seen as being tough on crime.

Patricia: I mean, even Democrats want to see themselves as being tough on crime. And so they end up supporting I mean, you see like the rescinding of the Measure 110 in Oregon, right? I think it's a really sad thing. I mean, it could be that Oregon, it's more progressive. Maybe it'll work it out in such a way that ends up being not as horrifying.

Patricia: One of the most horrifying things for me is this drug induced homicide laws where it, because it creates divisions among parents who should be on the same page. And so you have parents who would never agree with me, right? Because they would look at my son and they would say, Oh, he's an addict, but their son was poisoned.

Patricia: And to me, that's very sad and I can understand it. You know, I mean, I was there. I understand that kind of trauma when you lose your child, but that's just, (sigh) we know that the war on drugs has not worked. And so why would we want to go back to further criminalization? I think it's just, you know mind boggling.

Mike: What did you come up with when you said, why my kid?

Patricia: Why my kid? I think, I mean, that's really the whole, you know. (chuckle)

Mike: It's the whole book, right?

Patricia: The whole book is you know, why my kid? I, I think that for him it was very much self medicating. So you know, he wasn't one of these people who got Oxycontin for a car accident and, you know, got then sucked into it, but I don't think it's, I mean, one of the things that I try to argue in the book is that it's not just choice, right?

Patricia: It's not just choice and it's not just brain disease, because choice and brain disease are very personalistic kinds of explanations, which a sociologist says, no, no, no, no, no, that's not the right, that's not the right thing. It's very satisfying though, you know, when you think about it, because it gives you easy answers, right?

Patricia: If you believe that it's choice, which a lot of people do, right? Then they're easy answers, right? The easy answer is, is that you take that, you know, what you call an addict, right? And what I call a substance user, and you throw them in jail. You shun the parents and the substance user. And that to me is not the answer.

Patricia: The answer is that you have to understand the broader social context in which those decisions are made. And that's really where I bring in the kind of sociology of what I talk about. I want to understand, you know, what were those broader social factors that led him. It's not that I don't argue.

Patricia: I'm very clear in the book. I don't argue that he's not in part responsible for the choices that he made, but you have to look at choice within those constraints. And that's what kind of makes it more of a sociological kind of argument. It makes it much more complex and nuance than a straight Oh, he chose this, right?

Patricia: This was his choice. And obviously he deserves the consequences of those choice. You know, it's like so many of these kids, they, I mean, Alex was 25 when he died and other kids die even earlier than that. And how can you say, I mean, their prefrontal cortex is not even fully developed at the time. So how can one say that it's so totally that it's just personal choice.

Patricia: I, I, Disagree with that every fiber in my body.

Mike: You know, you're I won't ask you to speak for him, but your husband Chip has his own section of the book towards the end. And I think he shares what a lot of families feel when a loved one dies this way he says pretty starkly, I failed my son.

Patricia: Yeah, isn't it a good chapter?

Patricia: I love that chapter.

Mike: Yeah, it's hard to... yeah, it's hard though hard.

Patricia: It's hard. It's hard to read I can't tell you since the book has come out a number of people have told me you want to meet my husband. This is exactly my husband, you know that I think people are saying this is this is like this is what...

Patricia: This is exactly what my husband says. I love that chapter because it's so raw and so emotional, and it's right there in the pain and right there in the grief, which is a good description of where he was. He always tells me, Oh, Pat, you know, you can compartmentalize so well, and it is true.

Patricia: I compartmentalize and I say, okay, what am I going to do? I'm going to write about it. And to me, that's my mechanism to you know, kind of protect myself and not let the grief overwhelm me. And so I'm pretty proud of this book as, because is it enabled me to, you know, writing it has enabled me to deal with the grief.

Patricia: Sometimes I think, oh, you know, what's gonna happen now? (chuckle) But, you know, I mean, it's just like, it's all the stuff that's required, you know, talking with people like you and other people, you know, it gives me that opportunity. So, you know, but I, I think it's good. I think all for all, it's been very good writing the book and enabling me to deal with it.

Patricia: He wrote that, I'm glad he wrote that chapter because

Mike: Yeah. And it comes towards the end of the book. Not to be a spoiler. You could, I'm sure read it outta order if you wanted to. But the interesting thing for me was that clearly after reading the book, you know, you both come at the issue from different perspectives, and then he says something so starkly, but, and I'll give you this as your walk away. In your dedication, in the beginning of the book, you dedicate the book to, in part, your husband Chip. You talk about, through it all, maintaining a loving relationship. So, take us out with this. Maintaining a loving relationship through trauma is?

Patricia: F and R!

Mike: (laugh)

Patricia: Not be too you know, like I won't swear, but really F and R because we were, as I mentioned earlier, we were so busy and I have since then, even recently, we moved to DC about two years ago and since we moved to DC, I remember going back and looking at my calendars and saying, I don't understand it.

Patricia: We were so busy, you know, both of us working full time. Chip was a guardian for the two children who moved in with us. Our niece and nephew who moved in with us because it was his brother's brother who died and his wife had died a few years earlier. So they moved in with us when they were quite young.

Patricia: And he was a guardian, so he had all of these responsibilities he had to deal with his brother's death, his mother died, you know, just like six weeks before his brother died, and so he was dealing with all this pain and all this grief. And then he also had a son who was spiraling out of control. So, you know, that's what you see reflected in his book.

Patricia: And, you know, for me I mean, obviously all those were quite painful for me, but we both of us just saw ourselves as, you know, people say, how can you do this? You know, how can you raise these two extra children? You're so good at doing it, blah, blah, blah. But it's like, you don't have any other choice, right?

Patricia: You just put one foot in front of the other and you grow to love them. And they are, I mean, I have to say, it's so weird that. Was that, you know, we lost our son and we gained two other children right at about, you know, within a couple of years of each other. And so they have brought us a lot of joy.

Patricia: They are our, you know, son and daughter now. Right. And they loved Alex. And so you just recreate, you sort of reintegrate that love that you have for your kid who you lost. You know, there's sociologists talk about how you talk about that. But that's what you, you just reintegrate that loss into your life and you just keep going and you kind of, you just keep that love that's there for the among this now enlarged family. (chuckle)

Mike: Right. Pat, I'm so grateful for your book and for you joining us today. I really appreciate it. And you all who are listening, I know are going to want to get it. It's just terrific. I got asked yesterday, Pat, by a friend, if I could just, where would I start to solve some of these problems? And I said, well, there's a bunch of different places you'd start.

Mike: And the thing I liked about your book was it not only weaves a personal, but also talked about common sense. Places to start that are cost effective, caring, and would work. So thanks for being with us and for your perseverance.

Patricia: Thanks for having me, I appreciate it, it was fun.

Mike: Yeah. For those of you listening, listening next time, if you can, until then stay safe and buy Pat's book.